title: Sensor-Based Electromagnetic Navigation (Mediguide®): How Accurate Is It? A Phantom Model Study.
abstract: BACKGROUND
  Data about localization reproducibility as well as spatial and visual accuracy of the new MediGuide® sensor-based electroanatomic navigation technology are scarce. We therefore sought to quantify these parameters based on phantom experiments.
  
  
  RESULTS
  A realistic heart phantom was generated in a 3D-Printer. A CT scan was performed on the phantom. The phantom itself served as ground-truth reference to ensure exact and reproducible catheter placement. A MediGuide® catheter was repeatedly tagged at selected positions to assess accuracy of point localization. The catheter was also used to acquire a MediGuide®-scaled geometry in the EnSite Velocity® electroanatomic mapping system. The acquired geometries (MediGuide®-scaled and EnSite Velocity®-scaled) were compared to a CT segmentation of the phantom to quantify concordance. Distances between landmarks were measured in the EnSite Velocity®- and MediGuide®-scaled geometry and the CT dataset for Bland-Altman comparison. The visualization of virtual MediGuide® catheter tips was compared to their corresponding representation on fluoroscopic cine-loops. Point localization accuracy was 0.5 ± 0.3 mm for MediGuide® and 1.4 ± 0.7 mm for EnSite Velocity®. The 3D accuracy of the geometries was 1.1 ± 1.4 mm (MediGuide®-scaled) and 3.2 ± 1.6 mm (not MediGuide®-scaled). The offset between virtual MediGuide® catheter visualization and catheter representation on corresponding fluoroscopic cine-loops was 0.4 ± 0.1 mm.
  
  
  CONCLUSIONS
  The MediGuide® system shows a very high level of accuracy regarding localization reproducibility as well as spatial and visual accuracy, which can be ascribed to the magnetic field localization technology. The observed offsets between the geometry visualization and the real phantom are below a clinically relevant threshold.
authors.affiliation: Department of Electrophysiology, German Heart Center Munich, Technische Universitaet Munich.
authors.forename: Felix
authors.initials: F
authors.lastname: Bourier
authors.affiliation: Department of Electrophysiology, German Heart Center Munich, Technische Universitaet Munich.
authors.forename: Tilko
authors.initials: T
authors.lastname: Reents
authors.affiliation: Department of Electrophysiology, German Heart Center Munich, Technische Universitaet Munich.
authors.forename: Sonia
authors.initials: S
authors.lastname: Ammar-Busch
authors.affiliation: Department of Electrophysiology, German Heart Center Munich, Technische Universitaet Munich.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Buiatti
authors.affiliation: Department of Electrophysiology, German Heart Center Munich, Technische Universitaet Munich.
authors.forename: Christian
authors.initials: C
authors.lastname: Grebmer
authors.affiliation: Department of Electrophysiology, German Heart Center Munich, Technische Universitaet Munich.
authors.forename: Marta
authors.initials: M
authors.lastname: Telishevska
authors.affiliation: Department of Electrophysiology, German Heart Center Munich, Technische Universitaet Munich.
authors.forename: Amir
authors.initials: A
authors.lastname: Brkic
authors.affiliation: Department of Electrophysiology, German Heart Center Munich, Technische Universitaet Munich.
authors.forename: Verena
authors.initials: V
authors.lastname: Semmler
authors.affiliation: Department of Electrophysiology, German Heart Center Munich, Technische Universitaet Munich.
authors.forename: Carsten
authors.initials: C
authors.lastname: Lennerz
authors.affiliation: Department of Electrophysiology, German Heart Center Munich, Technische Universitaet Munich.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Kaess
authors.affiliation: Department of Electrophysiology, German Heart Center Munich, Technische Universitaet Munich.
authors.forename: Marc
authors.initials: M
authors.lastname: Kottmaier
authors.affiliation: Department of Electrophysiology, German Heart Center Munich, Technische Universitaet Munich.
authors.forename: Christof
authors.initials: C
authors.lastname: Kolb
authors.affiliation: Department of Electrophysiology, German Heart Center Munich, Technische Universitaet Munich.
authors.forename: Isabel
authors.initials: I
authors.lastname: Deisenhofer
authors.affiliation: Department of Electrophysiology, German Heart Center Munich, Technische Universitaet Munich.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Hessling
mesh_terms: D018780:Body Surface Potential Mapping / Q000295:instrumentation* / Q000379:methods; D013504:Cardiovascular Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D017115:Catheter Ablation / Q000295:instrumentation* / Q000379:methods; D004574:Electromagnetic Fields; D004867:Equipment Design; D019544:Equipment Failure Analysis; D006801:Humans; D008280:Magnetics / Q000295:instrumentation*; D019047:Phantoms, Imaging; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D025321:Surgery, Computer-Assisted / Q000295:instrumentation* / Q000379:methods
keywords: 3D mapping system; catheter ablation; catheter navigation; image integration