title: Real-time correction of respiratory-induced cardiac motion during electroanatomical mapping procedures.
abstract: Treatment planning during catheter interventions in the heart is often based on electromechanical tissue characteristics obtained by endocardial surface mapping (ESM). Since studies have shown respiratory-induced cardiac motion of over 5 mm in different directions, respiratory motion may cause ESMs artifacts due to faulty interpolation. Hence, we designed and tested a real-time respiration-correction algorithm for ESM. An experimental phantom was used to design the correction algorithm which was subsequently evaluated in five pigs. A piezo-respiratory belt transducer was used to measure the respiration. The respiratory signal was inserted to the NOGA®XP electromechanical mapping system via the ECG leads. The results of the correction were assessed by measuring the displacement of a reference point and the registration error of the ESM on a CMR scan before and after correction. In the phantom experiment, the reference point displacement was 6.5 mm before and 1.1 mm after correction and the registration errors were 2.8 ± 2.2 and 1.9 ± 1.3 mm, respectively. In the animals, the average reference point displacement (apex) was reduced from 2.6 ± 1.0 mm before to 1.2 ± 0.3 mm after correction (P < 0.05). The in vivo registration error of the ESM and the CMR scan did not significantly improve. Even though the apical movement appreciated in pigs is small, the correction algorithm shows a decrease in displacement after correction. Application of this algorithm omits the use of the time-consuming respiratory gating during ESM and may lead to less respiratory artifacts in clinical endocardial mapping procedures.
authors.affiliation: Department of Cardiology, University Medical Centre Utrecht, E03.511, P.O. Box 85500, 3508, Utrecht, The Netherlands. R.vanes-2@umcutrecht.nl.
authors.forename: R
authors.initials: R
authors.lastname: van Es
authors.affiliation: Department of Cardiology, University Medical Centre Utrecht, E03.511, P.O. Box 85500, 3508, Utrecht, The Netherlands.|Interuniversity Cardiology Institute of the Netherlands (ICIN), Utrecht, The Netherlands.
authors.forename: F J
authors.initials: FJ
authors.lastname: van Slochteren
authors.affiliation: Department of Cardiology, University Medical Centre Utrecht, E03.511, P.O. Box 85500, 3508, Utrecht, The Netherlands.
authors.forename: S J
authors.initials: SJ
authors.lastname: Jansen Of Lorkeers
authors.affiliation: Department of Cardiology, University Medical Centre Utrecht, E03.511, P.O. Box 85500, 3508, Utrecht, The Netherlands.|Department of Technical Medicine, Faculty of Science and Technology, University of Twente, Enschede, The Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: Blankena
authors.affiliation: Department of Cardiology, University Medical Centre Utrecht, E03.511, P.O. Box 85500, 3508, Utrecht, The Netherlands.
authors.forename: P A
authors.initials: PA
authors.lastname: Doevendans
authors.affiliation: Department of Cardiology, University Medical Centre Utrecht, E03.511, P.O. Box 85500, 3508, Utrecht, The Netherlands.
authors.forename: S A J
authors.initials: SA
authors.lastname: Chamuleau
mesh_terms: D000465:Algorithms; D000818:Animals; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006321:Heart / Q000033:anatomy & histology* / Q000502:physiology*; D007091:Image Processing, Computer-Assisted; D009038:Motion; D019047:Phantoms, Imaging; D012119:Respiration; D034421:Sus scrofa; D014159:Transducers
keywords: CMR; Cardiac imaging; Electroanatomical mapping; Respiratory-induced cardiac motion