title: Use of New Imaging CARTO® Segmentation Module Software to Facilitate Ablation of Ventricular Arrhythmias.
abstract: A new imaging software (CARTO® Segmentation Module, Biosense Webster) allows preprocedural 3-D reconstruction of all heart chambers based on cardiac CT. We describe our initial experience with the new module during ablation of ventricular arrhythmias.
  
  
  
  Eighteen consecutive patients with idiopathic ventricular arrhythmias or ischemic ventricular tachycardia (VT) were studied. In the latter group, a combined endocardial and epicardial ablation was performed. Of the 14 patients with idiopathic arrhythmias, 12 were ablated in the outflow tract (OT), 1 in the midseptal left ventricle, and 1 at the left posterior fascicular area; acute successful ablation was achieved in 11 (78.6%) patients. The procedure was discontinued due to close proximity of the arrhythmia origin to the coronary arteries (CA) in 2 patients. Acute successful uncomplicated ablation was achieved in all 4 patients with ischemic VT. During ablation in the coronary cusps commissures, the CARTO® Segmentation Module accurately defined the cusps anatomy. The precise anatomic location provided by the module assisted in successfully ablating when information from activation mapping was not optimal, by ablating at the opposite side of the cusps. In addition, by demonstrating the precise location of the CA, it allowed safe ablation of arrhythmias that originated in close proximity to the CA both in the OT area and the epicardium, eliminating the need for repeat angiography.
  
  
  
  The CARTO® Segmentation Module is useful for accurate definition of the exact anatomic location of ventricular arrhythmias and for safely ablating them especially in close proximity to the CA.
authors.affiliation: Department of Cardiology, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Oholi
authors.initials: O
authors.lastname: Tovia-Brodie
authors.affiliation: Department of Cardiology, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Bernard
authors.initials: B
authors.lastname: Belhassen
authors.affiliation: Department of Cardiology, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Aharon
authors.initials: A
authors.lastname: Glick
authors.affiliation: Department of Cardiology, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Haim
authors.initials: H
authors.lastname: Shmilovich
authors.affiliation: Department of Radiology, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Galit
authors.initials: G
authors.lastname: Aviram
authors.affiliation: Department of Cardiology, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Raphael
authors.initials: R
authors.lastname: Rosso
authors.affiliation: Department of Cardiology, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Yoav
authors.initials: Y
authors.lastname: Michowitz
mesh_terms: D000200:Action Potentials; D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D055424:Cardiac-Gated Imaging Techniques; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D000072226:Computed Tomography Angiography / Q000379:methods*; D017023:Coronary Angiography / Q000379:methods*; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D012985:Software Design; D025321:Surgery, Computer-Assisted / Q000009:adverse effects / Q000379:methods*; D017180:Tachycardia, Ventricular / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*
keywords: 3-D imaging; CARTO; ablation; mapping; ventricular arrhythmia