School of Biomedical Engineering and Imaging Sciences, King's College, London, UK.
Centre for Cardiovascular Science, The University of Edinburgh, Scotland, UK.
Eur Heart J Cardiovasc Imaging. 2021 Dec 18;23(1):31-41. doi: 10.1093/ehjci/jeab205.
Atrial arrhythmias, including atrial fibrillation and atrial flutter, may be treated through catheter ablation. The process of atrial arrhythmia catheter ablation, which includes patient selection, pre-procedural planning, intra-procedural guidance, and post-procedural assessment, is typically characterized by the use of several imaging modalities to sequentially inform key clinical decisions. Increasingly, advanced imaging modalities are processed via specialized image analysis techniques and combined with intra-procedural electrical measurements to inform treatment approaches. Here, we review the use of multimodality imaging for left atrial ablation procedures. The article first outlines how imaging modalities are routinely used in the peri-ablation period. We then describe how advanced imaging techniques may inform patient selection for ablation and ablation targets themselves. Ongoing research directions for improving catheter ablation outcomes by using imaging combined with advanced analyses for personalization of ablation targets are discussed, together with approaches for their integration in the standard clinical environment. Finally, we describe future research areas with the potential to improve catheter ablation outcomes.
心房心律失常，包括心房颤动和心房扑动，可以通过导管消融来治疗。心房心律失常导管消融的过程包括患者选择、术前规划、术中指导和术后评估，通常采用多种成像方式来依次告知关键的临床决策。越来越多的先进成像方式通过专门的图像分析技术进行处理，并结合术中电测量来指导治疗方法。在这里，我们回顾了多模态成像在左心房消融手术中的应用。本文首先概述了成像方式在消融前后的常规应用。然后，我们描述了先进的成像技术如何为消融患者的选择和消融靶点提供信息。讨论了结合先进分析技术来改善消融靶点个体化的成像指导消融的研究方向，以及将其整合到标准临床环境中的方法。最后，我们描述了具有改善导管消融结果潜力的未来研究领域。
