Fusion of multislice computed tomography and electroanatomical mapping data for 3D navigation of left and right atrial catheter ablation.
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.
Feuchtner
Gudrun M
GM
Department of Radiology II, Innsbruck Medical University, Anichstr. 35, Innsbruck A-6020, Austria. Gudrun.Feuchtner@i-med.ac.at
Dichtl
Wolfgang
W
DeFrance
Tony
T
Stühlinger
Markus
M
Klauser
Andrea
A
Berger
Thomas
T
Junker
Daniel
D
Spuller
Karin
K
Pachinger
Otmar
O
zur Nedden
Dieter
D
Hintringer
Florian
F
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