Imaging techniques in electrophysiology and implantable device procedures: results of the European Heart Rhythm Association survey

The purpose of this European Heart Rhythm Association (EHRA) survey is to assess the implementation and use of imaging techniques in cardiac electrophysiology (EP) and device procedures across European cardiovascular centres. Forty European centres, all members of the EHRA EP research network, responded to this survey. Thirty-one centres (88%) use transthoracic echocardiography (TTE) to evaluate left atrial size and/or volume before atrial fibrillation (AF) ablation. Sixteen centres (46%) perform delayed-enhancement cardiac magnetic resonance imaging (MRI) to guide ventricular tachycardia ablation. Electroanatomical mapping (EAM) systems are available in >65% of responding centres and the use of robotic catheter and remote magnetic navigation systems is limited to <10%. Fusion of EAM data with cardiac computed tomography (CT) and/or MRI is performed in up to 43% of AF ablation procedures. Seventeen out of 35 (49%) responding centres also perform TTE to predict a favourable response to cardiac resynchronization therapy (CRT). Imaging of the cardiac venous system with CT and identification of myocardial scar using CT or MRI, is not routinely performed in the majority of centres [32 (91%) and 26 (75%) centres, respectively) prior to CRT. This EHRA survey shows that several imaging techniques are used to guide catheter ablation and CRT procedures in European centres. Echocardiographic imaging, EAM techniques, and cardiac CT/MRI are commonly used.