Abstract
Background - New ablation strategies for atrial fibrillation or nonidiopathic ventricular tachycardia are increasingly based on anatomic consideration and require the placement of ablation lesions at the correct anatomic locations. This study sought to evaluate the accuracy of the first clinically available image integration system for catheter ablation on 3-dimensional (3D) computed tomography (CT) images in real time. Methods and Results - After midline sternotomy, 2.3-mm CT fiducial markers were attached to the epicardial surface of each cardiac chamber in 9 mongrel dogs. Detailed 3D cardiac anatomy was reconstructed from contrast-enhanced, high-resolution CT images and registered to the electroanatomic maps of each cardiac chamber. To assess accuracy, targeted ablations were performed at each of the fiducial markers guided only by the reconstructed 3D images. At autopsy, the position error was 1.9±0.9 mm for the right atrium, 2.7±1.2 mm for the right ventricle, 1.8±1.0 mm for the left atrium, and 2.3±1.1 mm for the left ventricle. To evaluate the system's guidance of more complex clinical ablation strategies, ablations of the cavotricuspid isthmus (n=4), fossa ovalis (n=4), and pulmonary veins (n=6) were performed, which resulted in position errors of 1.8± 1.5, 2.2±1.3, and 2.1±1.2 mm, respectively. Retrospective analysis revealed that a combination of landmark registration and the target chamber surface registration resulted in
| Original language | English (US) |
|---|---|
| Pages (from-to) | 186-194 |
| Number of pages | 9 |
| Journal | Circulation |
| Volume | 113 |
| Issue number | 2 |
| DOIs | |
| State | Published - Jan 2006 |
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Keywords
- Catheter ablation
- Electrophysiology
- Imaging
- Mapping
ASJC Scopus subject areas
- Physiology
- Cardiology and Cardiovascular Medicine
Cite this
Integrated electroanatomic mapping with three-dimensional computed tomographic images for real-time guided ablations. / Dong, Jun; Calkins, Hugh; Solomon, Stephen B.; Lai, Shenghan; Dalal, Darshan; Lardo, Al; Brem, Erez; Preiss, Assaf; Berger, Ronald D; Halperin, Henry R; Dickfeld, Timm.
In: Circulation, Vol. 113, No. 2, 01.2006, p. 186-194.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Integrated electroanatomic mapping with three-dimensional computed tomographic images for real-time guided ablations
AU - Dong, Jun
AU - Calkins, Hugh
AU - Solomon, Stephen B.
AU - Lai, Shenghan
AU - Dalal, Darshan
AU - Lardo, Al
AU - Brem, Erez
AU - Preiss, Assaf
AU - Berger, Ronald D
AU - Halperin, Henry R
AU - Dickfeld, Timm
PY - 2006/1
Y1 - 2006/1
N2 - Background - New ablation strategies for atrial fibrillation or nonidiopathic ventricular tachycardia are increasingly based on anatomic consideration and require the placement of ablation lesions at the correct anatomic locations. This study sought to evaluate the accuracy of the first clinically available image integration system for catheter ablation on 3-dimensional (3D) computed tomography (CT) images in real time. Methods and Results - After midline sternotomy, 2.3-mm CT fiducial markers were attached to the epicardial surface of each cardiac chamber in 9 mongrel dogs. Detailed 3D cardiac anatomy was reconstructed from contrast-enhanced, high-resolution CT images and registered to the electroanatomic maps of each cardiac chamber. To assess accuracy, targeted ablations were performed at each of the fiducial markers guided only by the reconstructed 3D images. At autopsy, the position error was 1.9±0.9 mm for the right atrium, 2.7±1.2 mm for the right ventricle, 1.8±1.0 mm for the left atrium, and 2.3±1.1 mm for the left ventricle. To evaluate the system's guidance of more complex clinical ablation strategies, ablations of the cavotricuspid isthmus (n=4), fossa ovalis (n=4), and pulmonary veins (n=6) were performed, which resulted in position errors of 1.8± 1.5, 2.2±1.3, and 2.1±1.2 mm, respectively. Retrospective analysis revealed that a combination of landmark registration and the target chamber surface registration resulted in
AB - Background - New ablation strategies for atrial fibrillation or nonidiopathic ventricular tachycardia are increasingly based on anatomic consideration and require the placement of ablation lesions at the correct anatomic locations. This study sought to evaluate the accuracy of the first clinically available image integration system for catheter ablation on 3-dimensional (3D) computed tomography (CT) images in real time. Methods and Results - After midline sternotomy, 2.3-mm CT fiducial markers were attached to the epicardial surface of each cardiac chamber in 9 mongrel dogs. Detailed 3D cardiac anatomy was reconstructed from contrast-enhanced, high-resolution CT images and registered to the electroanatomic maps of each cardiac chamber. To assess accuracy, targeted ablations were performed at each of the fiducial markers guided only by the reconstructed 3D images. At autopsy, the position error was 1.9±0.9 mm for the right atrium, 2.7±1.2 mm for the right ventricle, 1.8±1.0 mm for the left atrium, and 2.3±1.1 mm for the left ventricle. To evaluate the system's guidance of more complex clinical ablation strategies, ablations of the cavotricuspid isthmus (n=4), fossa ovalis (n=4), and pulmonary veins (n=6) were performed, which resulted in position errors of 1.8± 1.5, 2.2±1.3, and 2.1±1.2 mm, respectively. Retrospective analysis revealed that a combination of landmark registration and the target chamber surface registration resulted in
KW - Catheter ablation
KW - Electrophysiology
KW - Imaging
KW - Mapping
UR - http://www.scopus.com/inward/record.url?scp=33645010220&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33645010220&partnerID=8YFLogxK
U2 - 10.1161/CIRCULATIONAHA.105.565200
DO - 10.1161/CIRCULATIONAHA.105.565200
M3 - Article
C2 - 16401772
AN - SCOPUS:33645010220
VL - 113
SP - 186
EP - 194
JO - Circulation
JF - Circulation
SN - 0009-7322
IS - 2
ER -