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Image integration in electroanatomic mapping

Bildintegration beim elektrophysiologischen Mapping

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Zusammenfassung

Während der letzten fünf Jahre hat die Integration von Kernspintomographie (MRI) und Computertomographie (CT) komplexe, anatomische Ablationsverfahren deutlich erleichtert. Es erlaubte eine detail-genauere Darstellung der individuellen Herzanatomie, nachdem die MRIs und CTs segmentiert und anschliessend registriert wurden. Klinische Studien haben die Anwendbarkeit dieser Verfahren für die Ablation von Vorhofflimmern deutlich gemacht. Eine exakte Registrierung kann allerdings technisch schwierig sein und verschiedene Algorithmen benötigen. Die Integration der genauen Anatomie eröffnet jedoch die Möglichkeit einer sichereren und effizienteren Ablationsstrategie für Vorhofflimmern und ventrikulären „Reentry“-tachycardien. Neue Entwicklungen wie die Integration von pathophysiologischen Informationen oder Echt-Zeit-Komponenten werden in der Zukunft neue und genauere Behandlungsmethoden ermöglichen.

Abstract

Over the past five years, integration of the pre-procedural MR/CT images with a 3D electroanatomic mapping system has been developed to facilitate catheter ablation of clinical arrhythmias. It presents a significant advantage over the less-detailed surrogate geometry created by the 3D mapping systems. The process of image integration consists of pre-procedural imaging, image segmentation and image registration. Clinical studies have demonstrated the feasibility and accuracy of the use of image integration to guide catheter ablation of atrial fibrillation (AF). Accurate registration of the 3D left atrial MR/CT image to the real-time catheter mapping space can be technically challenging. Several important considerations should be taken into account to minimize registration error. Enhanced ability of catheter navigation with image integration may improve the efficacy and safety of anatomically based ablation strategies such as ablations of AF and nonidiopathic ventricular tachycardia. New developments in the field include integration of pathophysiologic as well as real-time anatomic information to the 3D mapping systems, and the use of new navigation system to improve registration.

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Authors and Affiliations

  1. The Johns Hopkins Hospital, 600 North Wolfe Street, Carnegie 592, Baltimore, MD, 21287, USA

    J. Dong MD, PhD

  2. Department of Cardiology, University of Maryland, 22 S. Greene Str., Room N3W77, Baltimore, MD, 21201, USA

    T. Dickfeld MD, PhD

Authors
  1. J. Dong MD, PhD
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  2. T. Dickfeld MD, PhD
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Corresponding author

Correspondence to J. Dong MD, PhD.

Additional information

Drs Dong and Dickfeld are consultants of and received research grants from Biosense Webster Inc.

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Dong, J., Dickfeld, T. Image integration in electroanatomic mapping. Herzschr. Elektrophys. 18, 122–130 (2007). https://doi.org/10.1007/s00399-007-0571-z

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  • DOI: https://doi.org/10.1007/s00399-007-0571-z

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