Arrhythmias & electrophysiologyCohort study
Simulation of peri-mitral ablation lines using photon-counting computed tomography-based mapping of atrial wall thickness and epicardial adipose tissue
- prospective imaging study with simulated ablation lines
Authors' conclusion
PCCT/3D-segmentation as a tool to visualize MT and EAT is very helpful to determine the most favorable line for catheter ablation of peri-mitral flutter. In a weighted score incorporating MT, EAT, and line length, AS and MII lines showed promising profiles for the creation of durable linear lesions.
Study context
- Population
- Patients undergoing photon-counting computed tomography (photon-counting computer tomography (PCCT)) of the left atriumpatients prospectively included, 990 simulated lines, 115,763 data points
- Participants
- 198 patients
- Exposure
- patterns of myocardial thickness (MT), epicardial adipose tissue (EAT), and length of commonly used left atrium (LA) lines
Main finding
As reported in the abstract
Line length
- Line length was shortest in MII, longest in anteromedial (AM)
Observational data: associations, not effects.
Further findings
MT
- Anteroseptal (AS) showed the lowest average MT values
- MT interpatient variability was greatest along the MIS
EAT
- EAT distributed inhomogenously at the anterior wall, thicker medially and especially laterally; highest EAT levels along the anterolateral line (AL) line
Weighted score (MT, EAT, line length)
- AS and MII lines demonstrated the most favorable profiles for catheter ablation
Original publication
Simulation of peri-mitral ablation lines using photon-counting computed tomography-based mapping of atrial wall thickness and epicardial adipose tissue. Heart Rhythm. Published 8 January 2026. doi:10.1016/j.hrthm.2026.01.001
Summarised from the published abstract; every number is checked against it