Abstract 629: 3D Integration of Intracardiac Echocardiography and Multi-Slice Computed Tomography to Facilitate Radiofrequency Catheter Ablation for Atrial Fibrillation
Background: Integration of multi-slice computed tomography (MSCT) and electroanatomical mapping (EAM) is commonly used to guide radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF). However, MSCT fails to provide real-time anatomical information which may result in less accurate lesion placement. Intracardiac echocardiography (ICE) allows acquisition of real-time anatomical information.
Methods: In seventeen patients undergoing RFCA for AF, three-dimensional (3D) mapping of the left atrium (LA) and pulmonary veins (PVs) was performed using a new mapping system and a modified ICE catheter that allow integration of ICE with EAM. By tracing endocardial contours on each ICE image, a registered 3D shell of the LA and PVs was generated. A MSCT image was then integrated by performing a registration process (Figure 1⇓).
Results: An accurate 3D geometry of the LA and PVs was acquired in all patients by integrating ICE with a mean number of 31 ± 8.5 ICE contours (range 18– 43). Integration of MSCT was subsequently performed in all patients and resulted in a mean distance between MSCT and ICE contours of 2.2 ± 0.3 mm (range 1.7–2.8 mm). The mean distance between MSCT and ICE contours around the PV ostia was 1.7 ± 0.2 mm.
Conclusion: Creating a 3D map of the LA with ICE is feasible and accurate. The 3D map can additionally be integrated with MSCT. Integration of ICE may improve guidance during RFCA for AF. Figure 1⇓ A 3D map was created by tracing endocardial contours on ECG gated intracardiac echocardiography (ICE) images of the left atrium and pulmonary veins. The multi-slice computed tomography (MSCT) image has been integrated with the 3D map created with ICE.