Rotational Angiography (DynaCT) and Its Use in Guiding Ablation Procedures in Chambers Other than Left Atrium

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Aims: To assess the usefulness of rotational angiography using DynaCT (Seimens) 3D reconstruction of cardiac chambers in guiding ablation in complex cardiac arrhythmia involving chambers other than Left Atrium. DynaCT and have proven to be helpful in left atrial reconstruction, however its usefulness in ablation procedures involving other cardiac chambers in unknown. Methods: Mapping and ablation was done in 13 patients with concomitant DynaCT and 3D Electroanatomic mapping using NavX or Ensite System (SJM). DynaCT was used to create 3D images of the heart chambers and the 3D image superimposed on live fluoro. Results: RA was reconstructed in 4, LV in 5 and RV in 3 patients. Additionally the aortic root and left coronary ostium was reconstructed in 1 patient. In all pts 3D reconstruction was possible and the image was overlayed on real time fluoroscopic image to guide catheter manipulation and ablation. The time required to produce a 3D image was 5–15 (8.3±4.7) minutes. LV aneurysm was delineated in 3 patients allowing definition of aneurysm along its edges. Conclusion: DynaCT can be used to create 3D images of any chamber of the heart. It improves accuracy of structural anatomy and allows catheter manipulation using real-time road-maps. It is an important aid in ablation procedures even in cases where electro-anatomic mapping is used.