OBJECTIVETo investigate the efficacy of integrated electroanatomic mapping with preacquired magnetic resonance (MR) images guided catheter atrial fibrillation (AF) ablation.

METHODSFrom September 2005 to September 2006, 100 consecutive drug-refractory AF patients underwent catheter ablation (circumferential pulmonary vein (PV) linear ablation and electrical isolation) guided by a three-dimensional (3D) electroanatomic mapping system. Patients were randomly divided into two groups (n = 50 each group). Registration before ablation group: integrated electroanatomic mapping with preacquired 3D MR images processed before ablation procedure; registration after ablation group: ablation procedures guided by CARTO system only. After ablation, image integration was processed in both groups.

RESULTSSinus rhythms were maintained in 32/50 and 33/50 patients without antiarrhythmics 3 months post ablation (P > 0.05). Upon completion of the circumferential lesions around the PVs, the distance between the surface of the registered 3D MR left atrium (LA) reconstruction and multiple electroanatomic map points was significantly shorter [(1.6 +/- 0.7) mm vs. (2.1 +/- 1.3) mm], radiofrequency application location points were significantly less (75 +/- 27 vs. 98 +/- 38) and the total fluoroscopy time were also significantly shorter [(31 +/- 21) min vs. (55 +/- 29) min] in the registration before ablation group compared to registration after ablation group (P all < 0.05). Mismatch numbers between the practical ablation line and calculated ablation line were significantly higher in registration after ablation group compared to registration before ablation group (142/213 vs. 71/213, P < 0.05).

CONCLUSIONIntegrated three-dimensional electroanatomic mapping with preacquired MR images technique could improve accuracy of catheter ablation, reduce fluoroscopy time and ablation location points for AF patients underwent ablation.