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Accuracy Assessment of Catheter Guidance Technology in Electrophysiology Procedures.

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  • معلومة اضافية
    • Subject Terms:
    • Author-Supplied Keywords:
      atrial fibrillation
      C‐arm CT
      C-arm CT
      CARTO
      catheter ablation
      EnSite
      image integration
      registration
    • NAICS/Industry Codes:
      621512 Diagnostic Imaging Centers
      811219 Other Electronic and Precision Equipment Repair and Maintenance
    • Abstract:
      Accuracy of Catheter Guidance Technology in the EP Lab Background With increasing complexity in electrophysiology (EP) procedures, the use of electroanatomic mapping systems (EAMS) as a supplement to fluoroscopy has become common practice. This is the first study that evaluates spatial and point localization accuracy for 2 current EAMS, CARTO3® (Biosense Webster, Diamond Bar, CA, USA) and EnSite Velocity® (St. Jude Medical Inc., St. Paul, MN, USA), and for a novel overlay guidance (OG) software (Siemens AG, Forchheim, Germany) in a phantom experiment. Methods and Results A C-arm CT scan was performed on an acrylic phantom containing holes and location markers. Spatial accuracy was assessed for each system using distance measurements involving known markers inside the phantom and properly placed catheters. Anatomical maps of the phantom were acquired by each EAMS, whereas the 3D-based OG software superimposed an overlay image of the phantom, segmented from the C-arm CT data set, onto biplane fluoroscopy. Registration processes and landmark measurements quantitatively assessed the spatial accuracy of each technology with respect to the ground truth phantom. Point localization performance was 0.49 ± 0.25 mm in OG, 0.46 ± 0.17 mm in CARTO3® and 0.79 ± 0.83 mm in EnSite®. The registration offset between virtual visualization and reality was 1.10 ± 0.52 mm in OG, 1.62 ± 0.77 mm in CARTO3® and 2.02 ± 1.21 mm in EnSite®. The offset to phantom C-arm CT landmark measurements was 0.30 ± 0.26 mm in OG, 0.24 ± 0.21 mm in CARTO3® and 1.32 ± 0.98 mm in EnSite®. Conclusions Each of the evaluated EP guidance systems showed a high level of accuracy; the observed offsets between the virtual 3D visualization and the real phantom were below a clinically relevant threshold of 3 mm. [ABSTRACT FROM AUTHOR]
    • Abstract:
      Copyright of Journal of Cardiovascular Electrophysiology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
    • Author Affiliations:
      1The Lucas Center, Department of Radiology, Stanford School of Medicine, Stanford California, USA
      2Department of Cardiovascular Diseases (partner site Munich Heart Alliance), German Heart Centre, Munich Germany
      3Cardiac Arrhythmia Service, Cardiovascular Medicine, Stanford School of Medicine, Stanford California, USA
      4Cardiac Arrhythmia Service, Hospital Barmherzige Brueder, Regensburg Germany
      5Siemens AG, Healthcare Sector, Forchheim Germany
    • Full Text Word Count:
      5412
    • ISSN:
      1045-3873
    • Accession Number:
      10.1111/jce.12264
    • Accession Number:
      93569389