(Circulation. 1997;96:2016-2021.)
© 1997 American Heart Association, Inc.
Articles |
Guidance of Radiofrequency Endocardial Ablation With Real-time Three-dimensional Magnetic Navigation System
From the Cardiovascular System Laboratory, The Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Correspondence to Shlomo A. Ben-Haim, MD, DSc, Cardiovascular System Laboratory, The Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Efron St, PO Box 9649, 31096 Haifa, Israel. E-mail sol{at}biomed.technion.ac.il
Background Ablation therapy for certain arrhythmias requires the formation of complex lesions based on electrical and anatomic mapping. We tested the accuracy and reproducibility of a nonfluoroscopic mapping and navigation (NFM) system to guide delivery of radiofrequency (RF) energy in the right atrium (RA) of swine.
Methods and Results The NFM system uses an ultralow magnetic field to measure the real-time three-dimensional (3D) location of the tip of the locatable catheter. While in stable contact with the endocardium, between 30 and 40 consecutive tip locations were sampled and used for the 3D reconstruction of the RA geometry. The location of the catheter tip was presented in real time, superimposed over the RA geometry. We selected a point on the 3D reconstruction and delivered RF energy to that site via the tip of the locatable catheter. The catheter was then completely withdrawn and renavigated twice to the same point, at which RF energy was delivered again. At autopsy, the distance between the centers of the three ablation points (mean±SEM) was 2.3±0.5 mm (n=27). Similarly, we used the NFM system to guide the generation of linear lesions. The measured length of the linear lesions on the NFM 3D view was close to the actual lesion length measured at autopsy (correlation coefficient, .96; P=.002; n=6). Furthermore, the location, shape, and continuity of the linear lesions corresponded to the autopsy findings.
Conclusions We conclude that the NFM system can guide the application of RF energy without the use of fluoroscopy in a highly accurate and reproducible manner.
Key Words: electrophysiology • arrhythmia • catheter ablation • mapping
This article has been cited by other articles:
 |
|
 |
|
  D. N. Stephens, M. O'Donnell, K. Thomenius, A. Dentinger, D. Wildes, P. Chen, K. K. Shung, J. Cannata, P. Khuri-Yakub, O. Oralkan, et al. Experimental Studies With a 9F Forward-Looking Intracardiac Imaging and Ablation Catheter J. Ultrasound Med., February 1, 2009; 28(2): 207 - 215. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. M. Tracy, M. Akhtar, J. P. DiMarco, D. L. Packer, H. H. Weitz, M. A. Creager, D. R. Holmes Jr, G. Merli, G. P. Rodgers, C. M. Tracy, et al. American College of Cardiology/American Heart Association 2006 Update of the Clinical Competence Statement on Invasive Electrophysiology Studies, Catheter Ablation, and Cardioversion: A Report of the American College of Cardiology/American Heart Association/American College of Physicians Task Force on Clinical Competence and Training Developed in Collaboration With the Heart Rhythm Society J. Am. Coll. Cardiol., October 3, 2006; 48(7): 1503 - 1517. [Full Text] [PDF]
|
|
|
|
 |
|
 F. Grothues, O. Wolfram, C. Fantoni, H. Boenigk, A. Götte, C. Tempelmann, H.U. Klein, and A. Auricchio Volume measurement by CARTOTM compared with cardiac magnetic resonance. Europace, January 1, 2006; 8(1): 37 - 41. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. C. Nielsen, H. Kottkamp, C. Piorkowski, J.-H. Gerds-Li, H. Tanner, and G. Hindricks Radiofrequency ablation in children and adolescents: results in 154 consecutive patients. Europace, January 1, 2006; 8(5): 323 - 329. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Gaita, R. Riccardi, D. Caponi, D. Shah, L. Garberoglio, L. Vivalda, A. Dulio, A. Chiecchio, E. Manasse, and R. Gallotti Linear Cryoablation of the Left Atrium Versus Pulmonary Vein Cryoisolation in Patients With Permanent Atrial Fibrillation and Valvular Heart Disease: Correlation of Electroanatomic Mapping and Long-Term Clinical Results Circulation, January 18, 2005; 111(2): 136 - 142. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Arenal, S. del Castillo, E. Gonzalez-Torrecilla, F. Atienza, M. Ortiz, J. Jimenez, A. Puchol, J. Garcia, and J. Almendral Tachycardia-Related Channel in the Scar Tissue in Patients With Sustained Monomorphic Ventricular Tachycardias: Influence of the Voltage Scar Definition Circulation, October 26, 2004; 110(17): 2568 - 2574. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Nademanee, J. McKenzie, E. Kosar, M. Schwab, B. Sunsaneewitayakul, T. Vasavakul, C. Khunnawat, and T. Ngarmukos A new approach for catheter ablation of atrial fibrillation: mapping of the electrophysiologic substrate J. Am. Coll. Cardiol., June 2, 2004; 43(11): 2044 - 2053. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Dickfeld, H. Calkins, M. Zviman, R. Kato, G. Meininger, L. Lickfett, R. Berger, H. Halperin, and S. B. Solomon Anatomic Stereotactic Catheter Ablation on Three-Dimensional Magnetic Resonance Images in Real Time Circulation, November 11, 2003; 108(19): 2407 - 2413. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Ernst, F. Ouyang, F. Lober, M. Antz, and K.-H. Kuck Catheter-induced linear lesions in theleft atrium in patients with atrial fibrillation: An electroanatomic study J. Am. Coll. Cardiol., October 1, 2003; 42(7): 1271 - 1282. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Arenal, E. Glez-Torrecilla, M. Ortiz, J. Villacastin, J. Fdez-Portales, E. Sousa, S. del Castillo, L. Perez de Isla, J. Jimenez, and J. Almendral Ablation of electrograms with an isolated, delayed component as treatment of unmappable monomorphic ventricular tachycardias in patients with structural heart disease J. Am. Coll. Cardiol., January 1, 2003; 41(1): 81 - 92. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Kornowski Left ventricular electromechanical mapping for determination of myocardial function and viability J. Am. Coll. Cardiol., September 18, 2002; 40(6): 1075 - 1078. [Full Text] [PDF]
|
|
|
|
 |
|
 J. Lessick, G. Hayam, A. Zaretsky, S. A. Reisner, Y. Schwartz, and S. A. Ben-Haim Evaluation of inotropic changes in ventricular function by NOGA mapping: comparison with echocardiography J Appl Physiol, August 1, 2002; 93(2): 418 - 426. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Ricard, M. Imianitoff, K. Yaici, J. M. Coutelour, M. Bergonzi, J. P. Rinaldi, and N. Saoudi Atypical atrial flutters Europace, January 1, 2002; 4(3): 229 - 239. [Abstract] [PDF]
|
|
|
|
|
|
P. Adragao, D. Cavaco, C. Aguiar, J. Palos, F. Morgado, R. Ribeiras, M. Abecasis, J. Neves, D. Bonhorst, and R. Seabra-Gomes Ablation of pulmonary vein foci for the treatment of atrial fibrillation. Percutaneous electroanatomical guided approach Europace, January 1, 2002; 4(4): 391 - 399. [Abstract] [PDF]
|
|
|
|
 |
|
 N Saoudi, F Cosio, A Waldo, S.A Chen, Y Iesaka, M Lesh, S Saksena, J Salerno, and W Schoels A classification of atrial flutter and regular atrial tachycardia according to electrophysiological mechanisms and anatomical bases. A Statement from a Joint Expert Group from the Working Group of Arrhythmias of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology Eur. Heart J., July 2, 2001; 22(14): 1162 - 1182. [PDF]
|
|
|
|
|
|
C. Reithmann, E. Hoffmann, U. Dorwarth, T. Remp, and G. Steinbeck Electroanatomical mapping for visualization of atrial activation in patients with incisional atrial tachycardias Eur. Heart J., February 1, 2001; 22(3): 237 - 246. [Abstract] [PDF]
|
|
|
|
|
|
C. M. Tracy, M. Akhtar, J. P. DiMarco, D. L. Packer, H. H. Weitz, W. L. Winters, J. L. Achord, A. W. Boone, J. W. Hirshfeld Jr, B. H. Lorell, et al. American College of Cardiology/American Heart Association Clinical Competence Statement on invasive electrophysiology studies, catheter ablation, and cardioversion: A report of the american college of cardiology/american heart association/american college of physicians-american society of internal medicine task force on clinical competence J. Am. Coll. Cardiol., November 1, 2000; 36(5): 1725 - 1736. [Full Text] [PDF]
|
|
|
|
|
|
C. M. Tracy, M. Akhtar, J. P. DiMarco, D. L. Packer, H. H. Weitz, W. L. Winters, J. L. Achord, A. W. Boone, J. W. Hirshfeld Jr, B. H. Lorell, et al. American College of Cardiology/American Heart Association Clinical Competence Statement on Invasive Electrophysiology Studies, Catheter Ablation, and Cardioversion : A Report of the American College of Cardiology/American Heart Association/American College of Physicians-American Society of Internal Medicine Task Force on Clinical Competence Circulation, October 31, 2000; 102(18): 2309 - 2320. [Full Text] [PDF]
|
|
|
|
|
|
F. E. Marchlinski, D. J. Callans, C. D. Gottlieb, and E. Zado Linear Ablation Lesions for Control of Unmappable Ventricular Tachycardia in Patients With Ischemic and Nonischemic Cardiomyopathy Circulation, March 21, 2000; 101(11): 1288 - 1296. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. A. Strickberger, B. P. Knight, G. F. Michaud, F. Pelosi, and F. Morady Mapping and ablation of ventricular tachycardia guided by virtual electrograms using a noncontact, computerized mapping system J. Am. Coll. Cardiol., February 1, 2000; 35(2): 414 - 421. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Bhargava and R. Kornowski Biosense Left Ventricular Electromechanical Mapping Asian Cardiovasc Thorac Ann, December 1, 1999; 7(4): 345 - 348. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Pappone, G. Oreto, F. Lamberti, G. Vicedomini, M. L. Loricchio, S. Shpun, M. Rillo, M. P. Calabro, A. Conversano, S. A. Ben-Haim, et al. Catheter Ablation of Paroxysmal Atrial Fibrillation Using a 3D Mapping System Circulation, September 14, 1999; 100(11): 1203 - 1208. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Gepstein, G. Hayam, S. Shpun, D. Cohen, and S. A. Ben-Haim Atrial Linear Ablations in Pigs : Chronic Effects on Atrial Electrophysiology and Pathology Circulation, July 27, 1999; 100(4): 419 - 426. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Gepstein, A. Goldin, J. Lessick, G. Hayam, S. Shpun, Y. Schwartz, G. Hakim, R. Shofty, A. Turgeman, D. Kirshenbaum, et al. Electromechanical Characterization of Chronic Myocardial Infarction in the Canine Coronary Occlusion Model Circulation, November 10, 1998; 98(19): 2055 - 2064. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Gepstein, G. Hayam, and S. A. Ben-Haim Activation-Repolarization Coupling in the Normal Swine Endocardium Circulation, December 2, 1997; 96(11): 4036 - 4043. [Abstract] [Full Text]
|
|
|
|
|
|
C. de Chillou, D. Lacroix, D. Klug, I. Magnin-Poull, C. Marquie, M. Messier, M. Andronache, C. Kouakam, N. Sadoul, J. Chen, et al. Isthmus Characteristics of Reentrant Ventricular Tachycardia After Myocardial Infarction Circulation, February 12, 2002; 105(6): 726 - 731. [Abstract] [Full Text] [PDF]
|
|