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Effect of Catheter Tip‐Tissue Surface Contact on Three‐Dimensional Left Atrial and Pulmonary Vein Geometries: Potential Anatomic Distortion of 3D Ultrasound, Fast Anatomical Mapping, and Merged 3D CT‐Derived Images
Author(s) -
OKUMURA YASUO,
WATANABE ICHIRO,
KOFUNE MASAYOSHI,
NAGASHIMA KOICHI,
SONODA KAZUMASA,
MANO HIROAKI,
OHKUBO KIMIE,
NAKAI TOSHIKO,
SASAKI NAOKO,
KOGAWA RIKITAKE,
MARUYAMA AYAKO,
HIRAYAMA ATSUSHI
Publication year - 2013
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/jce.12062
Subject(s) - medicine , 3d ultrasound , ablation , catheter ablation , pulmonary vein , atrial fibrillation , 3d reconstruction , fiducial marker , ultrasound , nuclear medicine , radiology , artificial intelligence , cardiology , computer science
Anatomic Distortion of 3D Mapping . Background: Although catheter tip‐tissue contact is known as a reliable basis for mapping and ablation of atrial fibrillation (AF), the effects of different mapping methods on 3‐dimensional (3D) map configuration remain unknown.Methods and Results:Twenty AF patients underwent C arto ‐based 3D ultrasound (US) evaluation. Left atrium (LA)/pulmonary vein (PV) geometry was constructed with the 3D US system. The resulting geometry was compared to geometries created with a fast electroanatomical mapping (FAM) algorithm and 3D US merged with computed tomography (merged 3D US‐CT). The 3D US‐derived LA volumes were smaller than the FAM‐ and merged 3D US‐CT‐derived volumes (75 ± 21 cm 3 vs 120 ± 20 cm 3 and 125 ± 25 cm 3 , P < 0.0001 for both). Differences in anatomic PV orifice fiducials between 3D US‐ and FAM‐ and merged 3D US‐CT‐derived geometries were 6.0 (interquartile range 0–9.3) mm and 4.1 (0–7.0) mm, respectively. Extensive encircling PV isolation guided by 3D US images with real‐time 2D intracardiac echocardiography‐based visualization of catheter tip‐tissue contact generated ablation point (n = 983) drop‐out at 1.9 ± 3.8 mm beyond the surface of the 3D US‐derived LA/PV geometry. However, these same points were located 1.5 ± 5.4 and 0.4 ± 4.1 mm below the FAM‐ and merged 3D US‐CT‐derived surfaces.Conclusions:Different mapping methods yield different 3D geometries. When AF ablation is guided by 3D US‐derived images, ablation points fall beyond the 3D US surface but below the FAM‐ or merged 3D US‐CT‐derived surface. Our data reveal anatomic distortion of 3D images, providing important information for improving the safety and efficacy of 3D mapping‐guided AF ablation. (J Cardiovasc Electrophysiol, Vol. 24, pp. 259‐266, March 2013)