The accuracy and clinical applicability of a sensor based electromagnetic nonfluoroscopic catheter tracking system

Shinya Yamada; Li-Wei Lo; Yenn-Jiang Lin; Shih-Lin Chang; Fa-Po Chung; Yu-Feng Hu; Ta-Chuan Tuan; Tze-Fan Chao; Jo-Nan Liao; Chin-Yu Lin; Shih-Ann Chen

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자료유형: 학술저널

저자정보: Shinya Yamada (Taipei Veterans General Hospital) Li-Wei Lo (National Yang-Ming University) Yenn-Jiang Lin (Taipei Veterans General Hospital) Shih-Lin Chang (National Yang-Ming University) Fa-Po Chung (Taipei Veterans General Hospital) Yu-Feng Hu (National Yang-Ming University) Ta-Chuan Tuan (National Yang-Ming University) Tze-Fan Chao (National Yang-Ming University) Jo-Nan Liao (National Yang-Ming University) Chin-Yu Lin (Taipei Veterans General Hospital) Shih-Ann Chen (Taipei Veterans General Hospital)

저널정보: 대한심장학회 Korean Circulation Journal Korean Circulation Journal Vol.49 No.1

발행연도: 2019.1

수록면: 84 - 96 (13page)

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Background and Objectives: The differences between electromagnetic-based mapping (EM) and impedance-based mapping (IM) in 3D anatomical reconstruction have not been fully clarified. We aimed to investigate the anatomical accuracy between EM (MediGuide™) and IM (EnSite Velocity™) systems. Methods: We investigated 15 consecutive patients (10 males, mean age 58±9 years) who underwent pulmonary veins (PVs) isolation for paroxysmal atrial fibrillation (PAF). Contrast-enhanced computed tomography (CT) image of the left atrium (LA) was acquired before ablation and the 3D geometry of the LA was constructed using EM during ablation procedure. We measured the 4 PV angles between the main trunk of each PV and the posterior LA after field scaling. Additionally, the posterior LA surface area was measured. The variables were compared to those of CT-based geometry. A control group of 40 patients who underwent conventional PVs isolation using IM were also evaluated. Results: The actual and relative changes of EM and CT-based geometry in all PV angles and posterior LA were significantly smaller compared to those of IM and CT-based geometry. Intraclass correlation coefficient (ICC) between EM and CT-based geometry were 0.871 (right superior pulmonary vein [RSPV]), 0.887 (right inferior pulmonary vein [RIPV]), 0.853 (left superior pulmonary vein [LSPV]), 0.911 (left inferior pulmonary vein [LIPV]), and 0.833 (posterior LA). On the other hand, ICC between IM and CT-based geometry were 0.548 (RSPV), 0.639 (RIPV), 0.691 (LSPV), 0.706 (LIPV), and 0.568 (posterior LA). Conclusions: Image integration with EM enables high accurate visualization of cardiac anatomy compared to IM in PAF ablation.

#Atrial fibrillation #Atrial flutter #Anatomy #Cardiovascular imaging #Fluoroscopy

참고문헌 (18)

참고문헌 신청

Cappato R / 2010 / Updated worldwide survey on the methods, efficacy, and safety of catheter ablation for human atrial fibrillation / Circ Arrhythm Electrophysiol 3:32~38

Estner HL / 2006 / Electrical isolation of pulmonary veins in patients with atrial fibrillation : reduction of fluoroscopy exposure and procedure duration by the use of a non-fluoroscopic navigation system(NavX) / Europace 8:583~587

Rolf S / 2012 / Ablation of atrial fibrillation using novel 4-dimensional catheter tracking within autoregistered left atrial angiograms / Circ Arrhythm Electrophysiol 5:684~690

Sommer P / 2014 / Nonfluoroscopic catheter visualization in atrial fibrillation ablation : experience from 375 consecutive procedures / Circ Arrhythm Electrophysiol 7:869~874

Bourier F / 2014 / Accuracy assessment of catheter guidance technology in electrophysiology procedures : a comparison of a new 3D-based fluoroscopy navigation system to current electroanatomic mapping systems / J Cardiovasc Electrophysiol 25:74~83

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이 논문의 저자 정보

Shinya Yamada

소속기관 Taipei Veterans General Hospital

주요연구분야 의약학 > 임상의학 > 내과학

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Li-Wei Lo