Computed tomography-fluoroscopy overlay evaluation during catheter ablation of left atrial arrhythmia
| Autor: | Hicham Skali, Pierre Jaïs, Mark D O'Neill, Olivier Corneloup, Isabelle Nault, Michael V. Orlov, Seiichiro Matsuo, Michel Haïssaguerre, Sébastien Knecht, Charles I. Haffajee, Michel Montaudon, Geert Gijsbers, Matthew Wright, François Laurent, Ghulam Muqtada Chaudhry, Mélèze Hocini, Frederic Sacher |
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| Rok vydání: | 2008 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Computed tomography Catheter ablation Overlay Pulmonary vein Physiology (medical) Atrial Fibrillation Humans Medicine Fluoroscopy Heart Atria Aged medicine.diagnostic_test business.industry Atrial fibrillation Middle Aged Ablation medicine.disease Equipment Failure Analysis Treatment Outcome Surgery Computer-Assisted Pulmonary Veins Catheter Ablation cardiovascular system Female Tomography Radiology Tomography X-Ray Computed Cardiology and Cardiovascular Medicine business |
| Zdroj: | Europace. 10:931-938 |
| ISSN: | 1532-2092 1099-5129 |
| Popis: | Proper visualization of left atrial (LA) and pulmonary vein (PV) anatomy is of crucial importance during atrial fibrillation (AF) ablation. This two-centre study evaluated a new automatic computed tomography (CT)-fluoroscopy overlay system (EP navigator, Philips Medical Systems, Best, The Netherlands) and the accuracy of different registration methods.Fifty-six consecutive patients (age: 56 +/- 14) with symptomatic AF underwent contrast CT of the LA/PV prior to ablation. Three registration methods were evaluated and validated by comparison with LA angiography: (i) catheter registration: the placement of catheters in identifiable anatomical structures; (ii) heart contour: based on aligning the fluoroscopy heart contours and the 3D-rendered CT volume; and (iii) spine registration: based on automatically aligning the segmented CT spine on fluoroscopy. Computed tomography segmentation was achieved in all but one patient due to motion artefacts. The mean duration of segmentation was 10 min and average registration lasted 7 min. Catheter and heart contour registration were highly accurate (discrepancy of 1.3 +/- 0.6 and 0.3 +/- 0.5 mm, respectively) when compared with spine registration (17 +/- 9 mm, P0.05). The EP navigator was helpful during trans-septal puncture, gave an internal view of the atria and allowed tracking of ablation lesions.The EP navigator enabled accurate live integration of CT images and real-time fluoroscopy. Registration utilizing catheter placement or heart contours was stable and reliable. |
| Databáze: | OpenAIRE |
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