title: Validation of accuracy of three-dimensional left atrial CartoSound™ and CT image integration: influence of respiratory phase and cardiac cycle.
abstract: BACKGROUND
  CartoSound™ (CS) module is useful in integrating 3-dimensional (3D) left atrial (LA) image with CT image. Integration method, however, has not been established. We reported the accuracy of LA electroanatomical (EA) and CT image integration by registering LA roof (LAR) and posterior wall (LAPW).
  
  
  METHODS
  The consecutive 56 atrial fibrillation patients undergoing pulmonary vein isolation were studied. In the initial 29 patients, before the transseptal puncture, 3D CS LAR and LAPW image was created by registering a mean of 10 contour lines between the right and left pulmonary veins. After transseptally inserting a mapping catheter into LA, 3D EA image of LAR and LAPW was obtained by sampling a mean of 40 points. LA CT image was taken at the full-inspiratory position and 0% of R-R interval. After visual alignment of CS or EA and LA CT image, the 2 images were integrated with surface registration program. In the latter 27 patients, both CT and CS images were taken while matching the respiratory phase at the end-tidal position and cardiac cycle at 50% of R-R interval.
  
  
  RESULTS
  In the initial 29 patients, the mean distances between EA and CT images and between CS and CT images were 1.53 ± 0.27 and 1.59 ± 0.23 mm, respectively (P = NS). In the latter 27, the mean distance was decreased to 1.08 ± 0.14 mm (P < 0.0001).
  
  
  CONCLUSIONS
  CS system is useful in image integration with 3D CT. Matching both respiratory phase and cardiac cycle between CS and CT image acquisition improves the image integration accuracy.
authors: Department of Cardiology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors: Masaomi
authors: M
authors: Kimura
authors: Shingo
authors: S
authors: Sasaki
authors: Shingen
authors: S
authors: Owada
authors: Daisuke
authors: D
authors: Horiuchi
authors: Kenichi
authors: K
authors: Sasaki
authors: Taihei
authors: T
authors: Itoh
authors: Yuji
authors: Y
authors: Ishida
authors: Takahiko
authors: T
authors: Kinjo
authors: Ken
authors: K
authors: Okumura
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D006328:Cardiac Catheterization / Q000592:standards; D017115:Catheter Ablation / Q000592:standards; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000601:surgery; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000592:standards*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015656:Respiratory Mechanics / Q000502:physiology*; D014057:Tomography, X-Ray Computed / Q000592:standards*
keywords: CartoSound; atrial fibrillation; catheter ablation; computed tomography; image integration; intracardiac echocardiography