Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing
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J Interv Card Electrophysiol · Jun 2000
Accuracy of fluoroscopic localization of the Crista terminalis documented by intracardiac echocardiography.
The crista terminalis is an important anatomic target for ablation of atrial arrhythmias. We determined the accuracy of catheter placement guided by fluoroscopy alone when directed to 24 sites along the crista terminalis in 6 patients. The sites selected included the most medial superior, most lateral superior, mid lateral, and most inferolateral sites along the crista terminalis in each patient. ⋯ In conclusion, it appears that using fluoroscopic guidance alone: 1) localization of the crista terminalis is frequently inaccurate and 2) catheter positioning in the superior/inferior vena cava is commonly noted when targeting very superior and inferior sites along the crista terminalis. A learning curve, assisted by review of ICE recordings after each procedure, appears to improve the accuracy of catheter placement by fluoroscopy alone but still does not result in uniform success. ICE appears to facilitate and ensure accurate targeting of specific anatomic sites along the crista terminalis and thus may serve as an important adjunctive imaging technique in electrophysiology.