Validation of three-dimensional cardiac image integration: use of integrated CT image into electroanatomic mapping system to perform catheter ablation of atrial fibrillation

Journal of Cardiovascular Electrophysiology
Peter M KistlerRichard J Schilling

Abstract

Accurate visualization of the complex left atrial (LA) anatomy and the location of an ablation catheter within the chamber is important in the success and safety of ablation for atrial fibrillation (AF). We describe the integration of CT into an electroanatomic mapping (EAM) system and its validation in patients undergoing catheter ablation for AF. Thirty patients (59.2 +/- 8 years, 25 M) with paroxysmal (12) and persistent (18) AF underwent ablation using CT image integration into an electroanatomic mapping system. CT registration using the pulmonary veins as markers (landmark) was achieved with an error of 6.4 +/- 2.8 mm with repeat registration required in two patients. Registration of the CT by best fit to a electroanatomic geometry (surface) was achieved with an error of 2.3 +/- 0.4 mm. There was no significant difference in the regional LA registration error at superior (1.7 +/- 0.7 mm), inferior (2.2 +/- 1.4 mm), septal (1.7 +/- 0.8 mm), and lateral (1.7 +/- 0.7 mm, P = 0.13) sites. Cardiac rhythm at the time of CT did not have a significant effect on total or regional surface registration accuracy (mean total 2.5 +/- 0.3 in AF patients vs 2.3 +/- 0.5 in SR patients, P = 0.22). The integrated CT was used to guide the enc...Continue Reading

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