An integrated intracardiac echocardiography catheter with 3D electrofield mapping successfully imaged cardiac anatomy and reduced the time to visualize and ablate 4 targeted sites in a porcine model.
Does an integrated intracardiac echocardiography catheter with 3D electrofield mapping improve visualization and reduce ablation time in a porcine model?
An integrated ICE catheter with 3D electrofield mapping is feasible for guiding cardiac EP interventions and may reduce ablation time in preclinical models.
OBJECTIVE: We have developed an integrated high-resolution intracardiac echocardiography (ICE) catheter for electrophysiology (EP) testing, which can be coregistered in 3-dimensional space with EP testing and ablation catheters using electrofield sensing. METHODS: Twelve open-chest pigs (34-55 kg) and 3 closed-chest pigs were studied. After introduction from the jugular or femoral venous locations, the 9F side-looking, highly steerable (0 degrees -180 degrees), 64-element array catheters could be manipulated easily throughout the right side of the heart. Multisite cardiac pacing was performed for assessing left ventricular (LV) synchrony using tissue Doppler methods. Also, in the open-chest pigs, right atrial (RA) and right ventricular (RV) ablations were performed with a separate radio frequency catheter under fluoroscopic guidance and visualized with ICE to characterize the changes. In the 3 closed-chest pigs, electrofield NavX 3-dimensional coregistration (St Jude Medical Corp, Minneapolis, MN) allowed us to test whether this additional feature could shorten the time necessary to perform 4 targeted ablations in each animal while imaging the ablation catheter and the adjacent region by ICE. RESULTS: Intracardiac anatomy, tricuspid, aortic, pulmonary, and mitral valve function, and pulmonary vein flow were all imaged reproducibly from scanning locations in the RA or RV in all animals, along with assessment of cardiac motion and the effects of multisite pacing. Three-dimensional electrofield displays detailed the spatial relationship between the ICE catheter and ablation catheters such that the time to visualize and ablate 4 sites in each of the 3 closed-chest animals was reduced. CONCLUSIONS: This new technology is a first step in the integration of ICE with EP procedures.
Li et al. (Thu,) conducted a other in Cardiac electrophysiology interventions (animal model) (n=15). EP-enabled intracardiac ultrasound catheter integrated with NavX 3-dimensional electrofield mapping was evaluated on Imaging reproducibility and time to visualize and ablate targeted sites. An integrated intracardiac echocardiography catheter with 3D electrofield mapping successfully imaged cardiac anatomy and reduced the time to visualize and ablate 4 targeted sites in a porcine model.
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