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Dynamic Registration of Preablation Imaging With a Catheter Geometry to Guide Ablation in a Swine Model: Validation of Image Integration and Assessment of Catheter Navigation Accuracy
Author(s) -
WEST J. JASON,
PATEL AMIT R.,
KRAMER CHRISTOPHER M.,
HELMS ADAM S.,
OLSON ERIC S.,
RANGAVAJHALA VAMSEE,
FERGUSON JOHN D.
Publication year - 2010
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.2009.01572.x
Subject(s) - medicine , ablation , catheter ablation , ventricle , catheter , radiology , nuclear medicine , cardiology
Image Integration with a Catheter Mapping System. Background: Catheter ablation of atrial and ventricular tachyarrhythmia involves anatomically based cardiac ablation strategies. CT and MRI images provide the most detailed cardiac anatomy available. Integration of these images into a mapping system should produce detailed and accurate models suitable to guide ablation.Objective:The purpose of this study was to validate and assess the accuracy of a novel CT and MRI image integration algorithm designed to facilitate catheter navigation and ablation.Methods:Using a lateral thoracotomy, markers were sutured to the epicardial surface of each cardiac chamber in 12 swine. Detailed CT/MRI anatomy was imported into the mapping system. The CT/MRI image was then integrated with a detailed catheter geometry of the relevant chamber using a new image integration algorithm. The epicardial markers, identified from the CT/MRI images, were then displayed on the surface of the integrated image. Guided only by the integrated CT/MRI, a single RF lesion was directed at the corresponding endocardial site for each epicardial marker. At autopsy, the distance from the endocardial RF lesion to the target site was assessed.Results:The mean position error (CT/MRI) for the left atrium was 2.5 ± 2.4 mm/5.1 ± 3.9 mm, for the right atrium 6.2 ± 6.5 mm/4.3 ± 2.2 mm, for the right ventricle 6.2 ± 4.3 mm/6.6 ± 5.3 mm, and for the left ventricle 4.7 ± 3.4 mm/3.1 ± 2.7 mm. There was no cardiac perforation or tamponade.Conclusion:CT and MRI images can be effectively utilized for catheter navigation when integrated into a mapping system. This novel registration module with dynamic registration provides effective guidance for ablation. (J Cardiovasc Electrophysiol, Vol. 21, pp. 81–87, January 2010)