title: Fusion of multislice computed tomography and electroanatomical mapping data for 3D navigation of left and right atrial catheter ablation.
abstract: OBJECTIVE
  To assess whether fusion of multislice computed tomography (CT) images with electroanatomical (EA)-mapping data using a new image integration module (CartoMerge) is feasible and accurate to navigate ablation catheters in right and left atrial catheter ablation.
  
  
  METHODS
  Twenty-four patients were examined with ECG-gated cardiac multislice CT (64 mm x 0.6mm, 0.33 s) 1 day before left atrial (LA) (15 patients) radiofrequency or right atrial cavotricuspid isthmus ablation (9 patients). CT data were fused with the non-fluoroscopic EA-mapping data by using dedicated software (CartoMerge) and the value of CT was analysed.
  
  
  RESULTS
  In 23/24 (96%) patients, CT images could be fused with the EA-map. The alignment error was 2.16+/-0.35 mm. In 15/15 (100%) patients, CT added relevant anatomical information regarding the course of the esophagus or the pulmonary veins before LA-ablation. CT added useful information in only 3/8 (37.5%) of patients undergoing right atrial cavotricuspid isthmus ablation.
  
  
  CONCLUSIONS
  3D-navigation of RF-ablation catheters in the atria assisted by image fusion of multislice CT with EA-mapping data is feasible and accurate. CT added relevant anatomical information about the left atrium and the pulmonary veins before LA-ablation, CT also provided information about the course of the esophagus which might help to avoid thermal injury. CT image fusion might be of minor value before right atrial cavotricuspid isthmus catheter ablation.
authors.affiliation: Department of Radiology II, Innsbruck Medical University, Anichstr. 35, Innsbruck A-6020, Austria. Gudrun.Feuchtner@i-med.ac.at
authors.forename: Gudrun M
authors.initials: GM
authors.lastname: Feuchtner
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Dichtl
authors.forename: Tony
authors.initials: T
authors.lastname: DeFrance
authors.forename: Markus
authors.initials: M
authors.lastname: Stühlinger
authors.forename: Andrea
authors.initials: A
authors.lastname: Klauser
authors.forename: Thomas
authors.initials: T
authors.lastname: Berger
authors.forename: Daniel
authors.initials: D
authors.lastname: Junker
authors.forename: Karin
authors.initials: K
authors.lastname: Spuller
authors.forename: Otmar
authors.initials: O
authors.lastname: Pachinger
authors.forename: Dieter
authors.initials: D
authors.lastname: zur Nedden
authors.forename: Florian
authors.initials: F
authors.lastname: Hintringer
mesh_terms: D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging* / Q000601:surgery*; D018780:Body Surface Potential Mapping / Q000379:methods*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D013382:Subtraction Technique; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome