Initial experience in the use of integrated electroanatomic mapping with three-dimensional MR/CT images to guide catheter ablation of atrial fibrillation.
INTRODUCTION: No prior studies have reported the use of integrated electroanatomic mapping with preacquired magnetic resonance/computed tomographic (MR/CT) images to guide catheter ablation of atrial fibrillation (AF) in a series of patients. METHODS AND RESULTS: Sixteen consecutive patients with dr...
| Publicado en: | Journal of Cardiovascular Electrophysiology Vol. 17; no. 5; pp. 459 - 467 |
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| Autores principales: | , , , , , , , , , , , |
| Formato: | pictorial research Journal Article |
| Publicado: |
Wiley-Blackwell
May2006
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106305291&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106305291 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10453873 GSB jtl: Journal of Cardiovascular Electrophysiology issn: 10453873 maglogo: Y pubinfo: dt: May2006 vid: 17 iid: 5 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 106305291 106305291 2009216607 10.1111/j.1540-8167.2006.00425.x NLM16684014 106305291 ppf: 459 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Initial experience in the use of integrated electroanatomic mapping with three-dimensional MR/CT images to guide catheter ablation of atrial fibrillation. aug: au: Dong J Dickfeld T Dalal D Cheema A Vasamreddy CR Henrikson CA Marine JE Halperin HR Berger RD Lima JAC Bluemke DA Calkins H affil: Johns Hopkins Hospital, Carnegie 592, 600 N Wolfe Street, Baltimore, MD 21287-0409; jdong4@jhmi.edu sug: subj: Atrial Fibrillation Therapy Catheter Ablation Methods Magnetic Resonance Imaging Methods Tomography, X-Ray Computed Methods Descriptive Statistics Electrophysiology Female Fisher's Exact Test Heart Atrium Anatomy and Histology Male Middle Age Pulmonary Veins Anatomy and Histology Radiographic Image Interpretation, Computer-Assisted T-Tests Human Middle Aged: 45-64 years Female Male ab: INTRODUCTION: No prior studies have reported the use of integrated electroanatomic mapping with preacquired magnetic resonance/computed tomographic (MR/CT) images to guide catheter ablation of atrial fibrillation (AF) in a series of patients. METHODS AND RESULTS: Sixteen consecutive patients with drug-refractory AF underwent catheter ablation under the guidance of a three-dimensional (3D) electroanatomic mapping system (Carto, Biosense Webster, Inc., Diamond Bar, CA, USA). Gadolinium-enhanced MR (n = 8) or contrast-enhanced high-resolution CT (n = 8) imaging was performed within 1 day prior to the ablation procedures. Using a novel software package (CartoMerge, Biosense Webster, Inc.), the left atrium (LA) with pulmonary veins (PVs) was segmented and extracted for image registration. The segmented 3D MR/CT LA reconstruction was accurately registered to the real-time mapping space with a combination of landmark registration and surface registration. The registered 3D MR/CT LA reconstruction was successfully used to guide deployment of RF applications encircling the PVs. Upon completion of the circumferential lesions around the PVs, 32% of the PVs were electrically isolated. Guided by a circular mapping catheter, the remaining PVs were disconnected from the LA using a segmental approach. The distance between the surface of the registered 3D MR/CT LA reconstruction and multiple electroanatomic map points was 3.05 +/- 0.41 mm. No complications were observed. CONCLUSIONS: Three-dimensional MR/CT images can be successfully extracted and registered to anatomically guided clinical AF ablations. The display of detailed and accurate anatomic information during the procedure enables tailored RF ablation to individual PV and LA anatomy. pubtype: Academic Journal doctype: pictorial research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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