Usefulness of CartoMerge image integration module in catheter ablation of atrial fibrillation

Background: Anatomy assessment using Computer Tomography (CT) and Magnetic Resonance (MRI) is performed in patients undergoing pulmonary vein isolation (PVI). The aim of this analysis was to investigate whether electroanatomical 3D map and CT/MRI image integration using the CartoMerge system improves efficacy, reduces procedure time or fluoroscopy usage. Materials and methods: 57 patients undergoing PVI were divided in two groups: “Merge” (n=45 pts) and “non-Merge” (n=14 pts) depending on usage of image integration. PV isolation during procedure (acute PVI), procedure time, fluoroscopy time, number of radio frequency (RF) applications and AF recurrence during follow-up (Merge group: 12-24 months, non-Merge group: 9-18 months) were analyzed. Results: Intra-procedural PVI was equal in both groups (93%). Long-term efficacy, defined as absence of AF recurrence, was insignificantly higher in the Merge group (69,8% vs 50%, p=0,11793). Procedure time was significantly longer in the Merge group – 239,1 (±55,5) min. vs 192,4 (±44,5). Fluoroscopy time was similar in both groups 29,9 (±12,23) vs 24,6 (±26,5) min, (p=0,579). Number of RF applications was significantly higher in the Merge group 48,5 (±25,2) vs 27,2 (±14,9). Conclusions: CartoMerge did not improve the rate of acute PVI, long-term effectivity or fluoroscopy time. In the non-Merge group the procedure time was shorter and the number of applications was significantly smaller.