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Heart Rhythm. 2008 Oct;5(10):1403-10. doi: 10.1016/j.hrthm.2008.07.020. Epub 2008 Jul 24.

Real-time integration of intracardiac echocardiography and multislice computed tomography to guide radiofrequency catheter ablation for atrial fibrillation.

Author information

1
Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.

Abstract

BACKGROUND:

Multislice computed tomography (MSCT) integration is commonly used to guide radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF). MSCT provides detailed anatomical information but lacks the ability to provide real-time anatomy during RFCA. Intracardiac echocardiography (ICE) allows real-time visualization of cardiac structures.

OBJECTIVE:

The purpose of this study was to investigate the feasibility of three-dimensional (3D) anatomical mapping of the left atrium (LA) with ICE and integrating the 3D map with MSCT to facilitate RFCA for AF.

METHODS:

In 17 patients undergoing RFCA for AF, 3D mapping of the LA was performed with ICE using a new mapping system that allows tracking of a new ICE probe. On each ICE image, endocardial contours were traced and used to generate a 3D map of the LA and pulmonary veins (PVs). A preprocedurally acquired MSCT image of the LA was then integrated with the 3D map. Additionally, PV assessment with ICE was compared with MSCT.

RESULTS:

Accurate 3D mapping could be performed in all patients with a mean number of 31.1 +/- 8.5 contours. Integration with MSCT resulted in a mean distance between the MSCT and ICE contours of 2.2 +/- 0.3 mm for the LA and PVs together and of 1.7 +/- 0.2 mm around the PV ostia specifically. Agreement in the assessment of PV anatomy and diameters between ICE and MSCT was excellent.

CONCLUSION:

Three-dimensional ICE mapping of the LA is feasible. The 3D map created with ICE can be merged with MSCT to facilitate RFCA for AF.

PMID:
18783992
DOI:
10.1016/j.hrthm.2008.07.020
[Indexed for MEDLINE]

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