Accuracy Assessment of Catheter Guidance Technology in Electrophysiology Procedures

Bourier, Félix; Fahrig, Rebecca; Wang, F.H.R.S. Paul; Kurzidim, Klaus; Strobel, Norbert; Moore, Teri; Hinkel, Brad; Al-Ahmad, F.H.R.S. Amin

doi:10.1111/jce.12264

Cited by 41 publications

(15 citation statements)

References 16 publications

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“…Similarly, white matter signals fluctuation on T2-weighted BOLD contrast images are associated with aging and cerebral small vessel disease (SVD) [ 308 ]. Therefore, for accuracy assessment of catheter guidance technology in electrophysiology procedures a new 3D-based fluoroscopy navigation system is developed for electroanatomic mapping [ 74 ]. NAWM (normal appearing white matter) was found to have graded increases in cardiac pulsations due to age and SVD, independently.…”

Section: Anatomical Markersmentioning

confidence: 99%

Emerging Risk Biomarkers in Cardiovascular Diseases and Disorders

2015

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Present review article highlights various cardiovascular risk prediction biomarkers by incorporating both traditional risk factors to be used as diagnostic markers and recent technologically generated diagnostic and therapeutic markers. This paper explains traditional biomarkers such as lipid profile, glucose, and hormone level and physiological biomarkers based on measurement of levels of important biomolecules such as serum ferritin, triglyceride to HDLp (high density lipoproteins) ratio, lipophorin-cholesterol ratio, lipid-lipophorin ratio, LDL cholesterol level, HDLp and apolipoprotein levels, lipophorins and LTPs ratio, sphingolipids, Omega-3 Index, and ST2 level. In addition, immunohistochemical, oxidative stress, inflammatory, anatomical, imaging, genetic, and therapeutic biomarkers have been explained in detail with their investigational specifications. Many of these biomarkers, alone or in combination, can play important role in prediction of risks, its types, and status of morbidity. As emerging risks are found to be affiliated with minor and microlevel factors and its diagnosis at an earlier stage could find CVD, hence, there is an urgent need of new more authentic, appropriate, and reliable diagnostic and therapeutic markers to confirm disease well in time to start the clinical aid to the patients. Present review aims to discuss new emerging biomarkers that could facilitate more authentic and fast diagnosis of CVDs, HF (heart failures), and various lipid abnormalities and disorders in the future.

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Section: Anatomical Markersmentioning

confidence: 99%

Emerging Risk Biomarkers in Cardiovascular Diseases and Disorders

2015

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“…In contrast, CARTO ® technology was impedance-based as well as electromagnetic-based. In a phantom experiment a significantly better point localization by CARTO3 ® in comparison to EnSite Velocity ® could be demonstrated [19]. A randomized comparison of CARTOmerge ® vs. EnSite NavX ® in RFA for AF could demonstrate a significantly higher accuracy in lesion distance to the shell: 2.0 mm vs. 3.4 mm [20].…”

Section: Discussionmentioning

confidence: 90%

“…It should be noted that a single incorrect registration point could produce a shifted map with unprecise localization of the PV ostia. There are data showing a higher precision of the surface-merge without a subsequent registration step for the CARTO ® system in comparison to the point-by-point technique of EnSite ® [19]. The values ranged from 0.73 mm for CARTO3 ® vs. 2.02 mm for EnSite Velocity ® .…”

Section: Discussionmentioning

confidence: 98%

Rate of acquired pulmonary vein stenosis after ablation of atrial fibrillation referred to electroanatomical mapping systems: Does it matter?

et al. 2019

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Background: Thermal injury during radiofrequency ablation (RFA) of atrial fibrillation (AF) can lead to pulmonary vein stenosis (PVS). It is currently unclear if routine screening for PVS by imaging (echocardiography, computed tomography) is clinically meaningful and if there is a correlation between PVS and the electroanatomical mapping system (EAMS) used for the ablation procedure. It was therefore investigated in the current single center experience. Methods: All patients from January 2004 to December 2016 with the diagnosis of PVS after interventional ablation of AF by radiofrequency were retrospectively analyzed. From 2004 to 2007, transesophageal echocardiography was routinely performed as screening for RFA-acquired PVS (group A). Since 2008, diagnostics were only initiated in cases of clinical symptoms suggestive for PVS (group B). Results: The overall PVS rate after interventional RFA for AF of the documented institution is 0.72% (70/9754). The incidence was not influenced by screening: group A had a 0.74% PVS rate and group B a 0.72% rate (NS). Referred to as the EAMS, there were significant differences: 20/4229 (0.5%) using CARTO ® , 48/4510 (1.1%) using EnSite ® , 1/853 (0.1%) using MediGuide ® , and 1/162 (0.6%) using Rhythmia ®. Since 2009, no significant difference between technologies was found. Conclusions: The present analysis of 9754 procedures revealed 70 cases of PVS. The incidence of PVS is not related to screening but to the application of different EAMS. Possible explanations are technological backgrounds (magnetic vs. electrical), learning curves, operator experience, and work-flow differences. Furthermore, incorporation of new technologies seems to be associated with higher incidences of PVS before workflows are optimized.

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“…For the remaining 15% of the cases or if higher accuracy level, for example, 3 mm [ 29 ], is required, small manual adjustment may be necessary in these cases.…”

Section: Discussionmentioning

confidence: 99%

Contrast-Based 3D/2D Registration of the Left Atrium: Fast versus Consistent

Hoffmann

Kowalewski

Maier

et al. 2016

International Journal of Biomedical Imaging

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For augmented fluoroscopy during cardiac ablation, a preoperatively acquired 3D model of a patient's left atrium (LA) can be registered to X-ray images recorded during a contrast agent (CA) injection. An automatic registration method that works also for small amounts of CA is desired. We propose two similarity measures: The first focuses on edges of the patient anatomy. The second computes a contrast agent distribution estimate (CADE) inside the 3D model and rates its consistency with the CA as seen in biplane fluoroscopic images. Moreover, temporal filtering on the obtained registration results of a sequence is applied using a Markov chain framework. Evaluation was performed on 11 well-contrasted clinical angiographic sequences and 10 additional sequences with less CA. For well-contrasted sequences, the error for all 73 frames was 7.9 ± 6.3 mm and it dropped to 4.6 ± 4.0 mm when registering to an automatically selected, well enhanced frame in each sequence. Temporal filtering reduced the error for all frames from 7.9 ± 6.3 mm to 5.7 ± 4.6 mm. The error was typically higher if less CA was used. A combination of both similarity measures outperforms a previously proposed similarity measure. The mean accuracy for well contrasted sequences is in the range of other proposed manual registration methods.

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Accuracy Assessment of Catheter Guidance Technology in Electrophysiology Procedures

Abstract: 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.

Cited by 41 publications

References 16 publications

Emerging Risk Biomarkers in Cardiovascular Diseases and Disorders

Emerging Risk Biomarkers in Cardiovascular Diseases and Disorders

Rate of acquired pulmonary vein stenosis after ablation of atrial fibrillation referred to electroanatomical mapping systems: Does it matter?

Contrast-Based 3D/2D Registration of the Left Atrium: Fast versus Consistent

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