Novel uses of imaging in AF ablation.

Abstract

AF represents a significant burden for patients, clinicians and health policy makers alike. Catheter based AF ablation is gaining an increasing role as an effective treatment for AF, capable of reducing or even eliminating the disease. AF ablation relies on isolation of arrhthymogenic triggers and alteration of the atrial substrate by carefully targeted atrial ablation, using a minimally invasive approach. Pre-procedural CT, MRI and echocardiography are crucial in evaluating the degree of atrial remodelling which may impact of procedural success, as well as identification of crucial cardiac and non-cardiac adjacent structures, and LAA thrombus. Electro-anatomical mapping is the cornerstone of intra-procedural imaging, which can be optimised by integration with pre-procedural imaging. Other technologies such as 3D rotational angiograpy, intracardiac echocardiography and real-time MRI are improving the safety and efficacy of the procedure. Post-procedural MRI and CT can effectively monitor and evaluate procedural complications and atrial structure and remodelling. Recent patents demonstrate the wealth of technological advancements in AF ablation and are evident in multiple aspects of the procedure.