Real-time circumferential mapping catheter tracking for motion compensation in atrial fibrillation ablation procedures

Abstract

Abstract. Atrial fibrillation (AFib) has been identified as a major cause of stroke. Radiofrequency catheter ablation has become an increasingly important treatment option, especially when drug therapy fails. Navigation under X-ray can be enhanced by using augmented fluoroscopy. It renders overlay images from pre-operative 3-D data sets which are then fused with X-ray images to provide more details about the underlying soft-tissue anatomy. Unfortunately, these fluoroscopic overlay images are compromised by respiratory and cardiac motion. Various methods to deal with motion have been proposed. To meet clinical demands, they have to be fast. Methods providing a processing frame rate of 3 frames-per-second (fps) are considered suitable for interventional electrophysiology catheter procedures if an acquisition frame rate of 2 fps is used. Unfortunately, when working at a processing rate of 3 fps, the delay until the actual motion compensated image can be displayed is about 300 ms. By using a novel approach involving a 3-D catheter model, catheter segmentation and a distance transform, we can speed up motion compensation to 20 fps which results in a display delay of only 50 ms on a standard workstation for medical applications. Our method uses a constrained 2-D/3-D registration to perform catheter tracking, and it obtained a 2-D tracking error of 0.61 mm.

Accuracy Assessment of Catheter Guidance Technology in Electrophysiology Procedures

“…The new 3D‐based OG system also offers algorithms to take motion into account. One method is to track the circumferential mapping catheter when placed at the site of ablation and to shift fluoro overlay images accordingly . The clinical performance of this method relies on frequent use of fluoroscopy and has yet to be evaluated in further studies.…”

3D ablation catheter localisation using individual C-arm x-ray projections

“…The aim is to utilize the 3D information for registration and motion compensation of a preoperative 3D road map. The 3D accuracy results of 2.1 mm in 3D (Brost et al 2012) are promising. Housden et al (2012) have shown the successful 2D/3D registration of a transesophageal echocardiography probe in a clinical setting.…”

“…The purpose of this work is to investigate the potential of 3D catheter localization directly from 2D x-ray images that are currently used for catheter navigation. Previous work that aimed to extract 3D information from individual 2D divergent x-ray projections includes the publications from Fallavollita (2010), Brost et al (2010Brost et al ( , 2012, Housden et al (2012) and Haase et al (2013). Fallavollita et al extract a 3D position for the tip of an ablation catheter from a single fluoroscopy projection based on the projective scaling of the known width of the catheter's tip electrode.…”

Pulmonary Vein Isolation Supported by MRI‐Derived 3D‐Augmented Biplane Fluoroscopy: A Feasibility Study and a Quantitative Analysis of the Accuracy of the Technique

“…We propose that the strength of correlation can be transferred to the closely located preplanned antral ablation lines; however, the antral landmarks would not be definitively identifiable in fluoroscopy for a direct comparison. The influence of respiratory and cardiac motion on the overlay registration accuracy is currently under investigation 19,20 …”