Reconstruction of the Left Atrium for Atrial Fibrillation Ablation using
the Machine Learning CARTO 3 m-FAM Software
Abstract
IIntroduction: Atrial fibrillation (AF) ablation requires a precise
reconstruction of the left atrium (LA) and pulmonary veins (PV).
Model-based FAM (m-FAM) is a novel module recently developed for the
CARTO system which applies machine-learning techniques to LA
reconstruction. We aimed to evaluate the feasibility and safety of a
m-FAM guided AF ablation as well as the accuracy of LA reconstruction
using the cardiac computed tomography angiography (CTA) of the same
patient LA as gold standard, in 32 patients referred for AF ablation.
Methods: Consecutive patients undergoing AF ablation. The m-FAM
reconstruction was performed with the ablation catheter (Group 1) or a
Pentaray catheter (Group 2). The reconstruction accuracy was confirmed
prior to the ablation by verification of pre-specified landmarks of the
LA and PVs by intracardiac echocardiogram (ICE) visualization and
fluoroscopy. A cardiac CTA performed before the ablation was used as
gold standard of LA anatomy. For each patient, the m-FAM reconstruction
was compared to his/her cardiac CTA. Results: The m-FAM reconstruction
was accurate in all patients regardless the catheter used for mapping.
In 12% re acquisition of the LA landmarks was necessary to improve the
accuracy. m-FAM time was shorter in group 2 while the M-Fam fluoroscopy
time was similar. Pulmonary vein isolation was achieved in 100% of
patients without major complications. The m-FAM reconstructions
accurately resemble the cardiac CTA of the same patients. Conclusions:
The m-FAM module allows for rapid and precise reconstruction of the LA
and PV anatomy, which can be safely used to guide AF ablation.