Contrast-enhanced rotational X-ray imaging for intra-operative CT-like reconstruction provided anatomical information that compared favorably with pre-acquired imaging data for ablation guidance.
Does contrast-enhanced rotational X-ray imaging provide sufficient anatomical information for intra-operative guidance during atrial fibrillation ablation compared to pre-operative imaging?
Intra-operative contrast-enhanced rotational X-ray imaging provides CT-like 3D reconstructions of the left atrium and pulmonary veins that are of sufficient quality for guiding atrial fibrillation ablation.
Catheter-based ablation in the left atrium and pulmonary veins (LAPV) for treatment of atrial fibrillation in cardiac electrophysiology (EP) are complex and require knowledge of heart chamber anatomy. Electroanatomical mapping (EAM) is typically used to define cardiac structures by combining electromagnetic spatial catheter localization with surface models which interpolate the anatomy between EAM point locations in 3D. Recently, the incorporation of pre-operative volumetric CT or MR data sets has allowed for more detailed maps of LAPV anatomy to be used intra-operatively. Preoperative data sets are however a rough guide since they can be acquired several days to weeks prior to EP intervention. Due to positional and physiological changes, the intra-operative cardiac anatomy can be different from that depicted in the pre-operative data. We present an application of contrast-enhanced rotational X-ray imaging for CT-like reconstruction of 3D LAPV anatomy during the intervention itself. Depending on the heart size a single or two selective contrastenhanced rotational acquisitions are performed and CT-like volumes are reconstructed with 3D filtered back projection. In case of dual injection, the two volumes depicting the left and right portions of the LAPV are registered and fused. The data sets are visualized and segmented intra-procedurally to provide anatomical data and surface models for intervention guidance. Our results from animal and human experiments indicate that the anatomical information from intra-operative CT-like reconstructions compares favorably with preacquired imaging data and can be of sufficient quality for intra-operative guidance.
Manzke et al. (Thu,) conducted a other in Atrial fibrillation. Contrast-enhanced rotational X-ray imaging vs. Pre-acquired imaging data (CT or MR) was evaluated on Anatomical information quality for intra-operative guidance. Contrast-enhanced rotational X-ray imaging for intra-operative CT-like reconstruction provided anatomical information that compared favorably with pre-acquired imaging data for ablation guidance.