Document Detail

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.
MedLine Citation:
PMID:  19682169     Owner:  NLM     Status:  MEDLINE    
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 Jason West; Amit R Patel; Christopher M Kramer; Adam S Helms; Eric S Olson; Vamsee Rangavajhala; John D Ferguson
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't; Validation Studies     Date:  2009-08-11
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  21     ISSN:  1540-8167     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-05-21     Completed Date:  2010-09-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  81-7     Citation Subset:  IM    
University of Virginia Division of Cardiovascular Medicine, St. Paul, Minnesota, USA.
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MeSH Terms
Cardiovascular Surgical Procedures / methods*
Catheter Ablation / instrumentation,  methods*
Heart / radiography*
Magnetic Resonance Imaging / methods*
Models, Animal
Myocardium / pathology*
Preoperative Care / methods
Subtraction Technique
Surgery, Computer-Assisted / methods
Systems Integration
Tomography, X-Ray Computed / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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