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3 results on '"multidetector row-computed tomography"'

1. Variable Procedural Strategies Adapted to Anatomical Characteristics in Catheter Ablation of the Cavotricuspid Isthmus Using a Preoperative Multidetector Computed Tomography Analysis.

Author

KAJIHARA, KENTA, NAKANO, YUKIKO, HIRAI, YUKOH, OGI, HIROSHI, ODA, NOBORU, SUENARI, KAZUYOSHI, MAKITA, YUKO, SAIRAKU, AKINORI, TOKUYAMA, TAKEHITO, MOTODA, CHIKAAKI, FUJIWARA, MAI, WATANABE, YOSHIKAZU, KIGUCHI, MASAO, and KIHARA, YASUKI

Subjects
*ATRIAL fibrillation treatment, *RIGHT heart atrium, *CATHETER ablation, *CONFIDENCE intervals, *ELECTROPHYSIOLOGY, *EPIDEMIOLOGY, *FISHER exact test, *COMPUTERS in medicine, *STATISTICS, *T-test (Statistics), *THERAPEUTICS, *TOMOGRAPHY, *U-statistics, *LOGISTIC regression analysis, *DATA analysis, *DATA analysis software, *DESCRIPTIVE statistics, *ANATOMY
Abstract

Variable Strategies for CTI Ablation Objectives This study aimed to investigate the anatomical characteristics complicating cavotricuspid isthmus (CTI) ablation and the effectiveness of various procedural strategies. Methods and Results This study included 446 consecutive patients (362 males; mean age 60.5 ± 10.4 years) in whom CTI ablation was performed. A total of 80 consecutive patients were evaluated in a preliminary study. The anatomy of the CTI was evaluated by multidetector row-computed tomography (MDCT) prior to the procedure. A multivariate logistic regression analysis revealed that the angle and mean wall thickness of the CTI, a concave CTI morphology, and a prominent Eustachian ridge, were associated with a difficult CTI ablation (P < 0.01). In the main study, 366 consecutive patients were divided into 2 groups: a modulation group (catheter inversion technique for a concave aspect, prominent Eustachian ridge, and steep angle of the CTI or increased output for a thicker CTI) and nonmodulation group (conventional strategy). The duration and total amount of radiofrequency energy delivered were significantly shorter and smaller in the modulation group than those in the nonmodulation group (162.2 ± 153.5 vs 222.7 ± 191.9 seconds, P < 0.01, and 16,962.4 ± 11,545.6 vs 24,908.5 ± 22,804.2 J, P < 0.01, respectively). The recurrence rate of type 1 atrial flutter after the CTI ablation in the nonmodulation group was significantly higher than that in the modulation group (6.3 vs 1.7%, P = 0.02). Conclusion Changing the procedural strategies by adaptating them to the anatomical characteristics improved the outcomes of the CTI ablation. [ABSTRACT FROM AUTHOR]

Published
2013
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2. Variable Procedural Strategies Adapted to Anatomical Characteristics in Catheter Ablation of the Cavotricuspid Isthmus Using a Preoperative Multidetector Computed Tomography Analysis

Author

Kenta, Kajihara, Yukiko, Nakano, Yukoh, Hirai, Hiroshi, Ogi, Noboru, Oda, Kazuyoshi, Suenari, Yuko, Makita, Akinori, Sairaku, Takehito, Tokuyama, Chikaaki, Motoda, Mai, Fujiwara, Yoshikazu, Watanabe, Masao, Kiguchi, and Yasuki, Kihara

Subjects
Male, Time Factors, Original Articles, Middle Aged, multidetector row-computed tomography, eustachian ridge, Logistic Models, Treatment Outcome, Japan, Atrial Flutter, Predictive Value of Tests, Recurrence, Risk Factors, cavotricuspid isthmus, Multivariate Analysis, Preoperative Care, catheter ablation, Multidetector Computed Tomography, Humans, Female, Heart Atria, Prospective Studies, Electrophysiologic Techniques, Cardiac, Aged
Abstract

Variable Strategies for CTI Ablation Objectives This study aimed to investigate the anatomical characteristics complicating cavotricuspid isthmus (CTI) ablation and the effectiveness of various procedural strategies. Methods and Results This study included 446 consecutive patients (362 males; mean age 60.5 ± 10.4 years) in whom CTI ablation was performed. A total of 80 consecutive patients were evaluated in a preliminary study. The anatomy of the CTI was evaluated by multidetector row-computed tomography (MDCT) prior to the procedure. A multivariate logistic regression analysis revealed that the angle and mean wall thickness of the CTI, a concave CTI morphology, and a prominent Eustachian ridge, were associated with a difficult CTI ablation (P < 0.01). In the main study, 366 consecutive patients were divided into 2 groups: a modulation group (catheter inversion technique for a concave aspect, prominent Eustachian ridge, and steep angle of the CTI or increased output for a thicker CTI) and nonmodulation group (conventional strategy). The duration and total amount of radiofrequency energy delivered were significantly shorter and smaller in the modulation group than those in the nonmodulation group (162.2 ± 153.5 vs 222.7 ± 191.9 seconds, P < 0.01, and 16,962.4 ± 11,545.6 vs 24,908.5 ± 22,804.2 J, P < 0.01, respectively). The recurrence rate of type 1 atrial flutter after the CTI ablation in the nonmodulation group was significantly higher than that in the modulation group (6.3 vs 1.7%, P = 0.02). Conclusion Changing the procedural strategies by adaptating them to the anatomical characteristics improved the outcomes of the CTI ablation.

Published
2013

3. Variable procedural strategies adapted to anatomical characteristics in catheter ablation of the cavotricuspid isthmus using a preoperative multidetector computed tomography analysis

Abstract

Objectives: This study aimed to investigate the anatomical characteristics complicating cavotricuspid isthmus (CTI) ablation and the effectiveness of various procedural strategies. Methods and Results: This study included 446 consecutive patients (362 males; mean age 60.5±10.4 years) in whom CTI ablation was performed. A total of 80 consecutive patients were evaluated in a preliminary study. The anatomy of the CTI was evaluated by multidetector row-computed tomography (MDCT) prior to the procedure. Amultivariate logistic regression analysis revealed that the angle and mean wall thickness of the CTI, a concave CTImorphology, and a prominent Eustachian ridge, were associated with a difficult CTI ablation (P < 0.01). In the main study, 366 consecutive patients were divided into 2 groups: a modulation group (catheter inversion technique for a concave aspect, prominent Eustachian ridge, and steep angle of the CTI or increased output for a thicker CTI) and nonmodulation group (conventional strategy). The duration and total amount of radiofrequency energy delivered were significantly shorter and smaller in the modulation group than those in the nonmodulation group (162.2 ± 153.5 vs 222.7 ± 191.9 seconds, P < 0.01, and 16,962.4 ± 11,545.6 vs 24,908.5 ± 22,804.2 J, P < 0.01, respectively). The recurrence rate of type 1 atrial flutter after the CTI ablation in the nonmodulation group was significantly higher than that in the modulation group (6.3 vs 1.7%, P = 0.02). Conclusion: Changing the procedural strategies by adaptating them to the anatomical characteristics improved the outcomes of the CTI ablation., 広島大学(Hiroshima University), 博士(医学), Philosophy in Medical Science, doctoral

Published
2014

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