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Cardiac Electroanatomical 3D Mapping

Leon M Ptaszek, Boyce Moon, Guy Rozen, Srijoy Mahapatra, Moussa Mansour
INTRODUCTION: Manual, point-by-point electroanatomical mapping requires the operator to directly evaluate each point during map construction. Consequently, point collection can be a slow process. An automated 3D mapping system was developed with the goal of improving key mapping metrics, including map completion time and point density. METHODS: Automated 3D mapping software that includes morphology and cycle length discrimination functions for surface and intracardiac electrograms was developed...
January 2018: Journal of Cardiovascular Electrophysiology
Hasan Imanli, Shaun Bhatty, Jean Jeudy, Yousra Ghzally, Kiddy Ume, Rama Vunnam, Refael Itah, Mati Amit, John Duell, Vincent See, Stephen Shorofsky, Timm M Dickfeld
INTRODUCTION: Visualization of left atrial (LA) anatomy using image integration modules has been associated with decreased radiation exposure and improved procedural outcome when used for guidance of pulmonary vein isolation (PVI) in atrial fibrillation (AF) ablation. We evaluated the CARTOSEG™ CT Segmentation Module (Biosense Webster, Inc.) that offers a new CT-specific semiautomatic reconstruction of the atrial endocardium. METHODS: The CARTOSEG™ CT Segmentation Module software was assessed prospectively in 80 patients undergoing AF ablation...
September 13, 2017: Pacing and Clinical Electrophysiology: PACE
Steven E Williams, Catalina Tobon-Gomez, Maria A Zuluaga, Henry Chubb, Constantine Butakoff, Rashed Karim, Elena Ahmed, Oscar Camara, Kawal S Rhode
PURPOSE: Left atrial arrhythmia substrate assessment can involve multiple imaging and electrical modalities, but visual analysis of data on 3D surfaces is time-consuming and suffers from limited reproducibility. Unfold maps (e.g., the left ventricular bull's eye plot) allow 2D visualization, facilitate multimodal data representation, and provide a common reference space for inter-subject comparison. The aim of this work is to develop a method for automatic representation of multimodal information on a left atrial standardized unfold map (LA-SUM)...
October 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Matteo Casale, Maurizio Mezzetti, Viviana Tulino, Scarano Michele, Paolo Busacca, Giuseppe Dattilo
INTRODUCTION: Cardiac arrhythmias are challenging diseases in childhood. Most of them in pediatric subjects (90.2%) are atrioventricular reentrant tachycardias and atrioventricular nodal reentrant tachycardias. The standard 12-lead ECG is a highly accurate diagnostic tool but an invasive electrophysiological study is often required. The main concern about this kind of procedures is their invasive nature and the need of radiations, so antiarrhythmic agents are currently the first line therapy...
July 5, 2017: Current Vascular Pharmacology
Adrienne E Campbell-Washburn, Mohammad A Tavallaei, Mihaela Pop, Elena K Grant, Henry Chubb, Kawal Rhode, Graham A Wright
Cardiac magnetic resonance imaging (MRI) is appealing to guide complex cardiac procedures because it is ionizing radiation-free and offers flexible soft-tissue contrast. Interventional cardiac MR promises to improve existing procedures and enable new ones for complex arrhythmias, as well as congenital and structural heart disease. Guiding invasive procedures demands faster image acquisition, reconstruction and analysis, as well as intuitive intraprocedural display of imaging data. Standard cardiac MR techniques such as 3D anatomical imaging, cardiac function and flow, parameter mapping, and late-gadolinium enhancement can be used to gather valuable clinical data at various procedural stages...
October 2017: Journal of Magnetic Resonance Imaging: JMRI
Tobias Weber, Hugo A Katus, Sebastian Sager, Eberhard P Scholz
BACKGROUND: Premature beats (PBs) are a common finding in patients suffering from structural heart disease, but they can also be present in healthy individuals. Catheter ablation represents a suitable therapeutic approach. However, the exact localization of the origin can be challenging, especially in cases of low PB burden during the procedure. OBJECTIVE: The aim of this study was to develop an automated mapping algorithm on the basis of the hypothesis that mathematical optimization would significantly accelerate the localization of earliest activation...
June 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Alexandre Costet, Elaine Wan, Ethan Bunting, Julien Grondin, Hasan Garan, Elisa Konofagou
Characterization and mapping of arrhythmias is currently performed through invasive insertion and manipulation of cardiac catheters. Electromechanical wave imaging (EWI) is a non-invasive ultrasound-based imaging technique, which tracks the electromechanical activation that immediately follows electrical activation. Electrical and electromechanical activations were previously found to be linearly correlated in the left ventricle, but the relationship has not yet been investigated in the three other chambers of the heart...
November 21, 2016: Physics in Medicine and Biology
Apinya Bharmanee, Srinath Gowda, Harinder R Singh
BACKGROUND: Use of nonfluoroscopic 3-dimensional electroanatomic mapping (NF-3DEAM) in patients with congenital heart defects (CHDs) is not well reported. OBJECTIVE: The purpose of this study was to evaluate the feasibility, accuracy, and safety of NF-3DEAM in patients with CHDs. METHODS: Retrospective review of electrophysiologic study (EPS) in patients with CHD from 2009 to 2013 was conducted. Patients undergoing EPS with NF-3DEAM using the EnSite NavX system (St...
August 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Lakshmi Nagaraju, Dipika Menon, Peter F Aziz
BACKGROUND: Radiation exposure related to medical procedures carries known medical risk. Electrophysiology (EP) and catheter ablation procedures are traditionally performed under fluoroscopic guidance. Three-dimensional (3D) electroanatomical navigation systems decrease or eliminate fluoroscopy use in EP procedures. OBJECTIVE: The aim of this study was to assess the efficacy and outcome of a minimal or no fluoroscopic electroanatomical mapping approach for catheter ablations for supraventricular tachycardia (SVT) in the pediatric population...
June 2016: Pacing and Clinical Electrophysiology: PACE
Bradley C Clark, Charles I Berul
Arrhythmias, covering bradycardia and tachycardia, occur in association with congenital heart disease (CHD) and as a consequence of surgical repair. Symptomatic bradycardia can occur due to sinus node dysfunction or atrioventricular block secondary to either unrepaired CHD or surgical repair in the area of the conduction system. Tachyarrhythmias are common in repaired CHD due to scar formation, chamber distension or increased chamber pressure, all potentially leading to abnormal automaticity and heterogeneous conduction properties as a substrate for re-entry...
2016: Expert Review of Cardiovascular Therapy
S J Podd, A N Sulke, C Sugihara, S S Furniss
PURPOSE: Pulmonary vein isolation (PVI) is conventionally performed using 3D electroanatomical mapping to guide point-to-point ablation. The Pulmonary Vein Ablation Catheter (PVAC)® is a phased multipolar ablation (PMRA) catheter designed for rapid PVI using radiological anatomical information. Comparison of these methods of PVI using continuous beat-to-beat monitoring was undertaken. METHODS: Fifty patients with drug-refractory, symptomatic paroxysmal atrial fibrillation (PAF) were recruited...
December 2015: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Amit K Mehrotra, David Callans
Treatment for ventricular tachycardia (VT) generally includes 1 or more of the following options: antiarrhythmic therapy, an implantable cardioverter-defibrillator and/or catheter ablation. Catheter ablation is performed with an electroanatomic mapping system to define the heart's 3D anatomy, as well as regions of scar. Radiofrequency energy is then applied to areas of abnormal substrate within which are located channels critical to the VT circuit. Cardiac magnetic resonance (CMR) imaging is a non-invasive modality that provides high-resolution images of cardiac structure and function...
2015: Circulation Journal: Official Journal of the Japanese Circulation Society
Ruken Özge Akbulak, Benjamin Schäffer, Mario Jularic, Julia Moser, Doreen Schreiber, Tim Salzbrunn, Christian Meyer, Christian Eickholt, Pawel Kuklik, Boris A Hoffmann, Stephan Willems
INTRODUCTION: Recently, a new image integration module (IIM, CartoUnivu™ Module) has been introduced to combine and merge fluoroscopy images with 3-dimensional-(3D)-electroanatomical maps (Carto® 3 System) into an accurate 3D view. The aim of the study was to investigate the influence of IIM on the fluoroscopy exposure during pulmonary vein isolation (PVI) for paroxysmal atrial fibrillation (PAF) in a prospective randomized trial. METHODS AND RESULTS: Between June and November 2014, a total of 60 patients with PAF (73...
July 2015: Journal of Cardiovascular Electrophysiology
Anees Thajudeen, Warren M Jackman, Brian Stewart, Ivan Cokic, Hiroshi Nakagawa, Michael Shehata, Allen M Amorn, Avinash Kali, Ezh Liu, Doron Harlev, Nathan Bennett, Rohan Dharmakumar, Sumeet S Chugh, Xunzhang Wang
BACKGROUND: Endocardial mapping for scars and abnormal electrograms forms the most essential component of ventricular tachycardia ablation. The utility of ultra-high resolution mapping of ventricular scar was assessed using a multielectrode contact mapping system in a chronic canine infarct model. METHODS: Chronic infarcts were created in five anesthetized dogs by ligating the left anterior descending coronary artery. Late gadolinium-enhanced magnetic resonance imaging (LGE MRI) was obtained 4...
June 2015: Pacing and Clinical Electrophysiology: PACE
Eric S Silver, Mary C Nash, Leonardo Liberman
BACKGROUND: Three-dimensional electroanatomic mapping systems (3D mapping) allow the creation of an anatomic representation of the cardiac anatomy and real-time monitoring of transvenous pacing catheters. Their use to facilitate pacemaker (PM) and implantable cardioverter defibrillator (ICD) lead placement in the pediatric population has not been well defined. We sought to review our experience using 3D mapping as an adjunct to fluoroscopy for positioning of permanent PM and ICD leads in pediatric patients...
April 2015: Pacing and Clinical Electrophysiology: PACE
David Andreu, Jose T Ortiz-Pérez, Juan Fernández-Armenta, Esther Guiu, Juan Acosta, Susanna Prat-González, Teresa M De Caralt, Rosario J Perea, César Garrido, Lluis Mont, Josep Brugada, Antonio Berruezo
AIMS: Non-invasive depiction of conducting channels (CCs) is gaining interest for its usefulness in ventricular tachycardia (VT) ablation. The best imaging approach has not been determined. We compared characterization of myocardial scar with late-gadolinium enhancement cardiac magnetic resonance using a navigator-gated 3D sequence (3D-GRE) and conventional 2D imaging using either a single shot inversion recovery steady-state-free-precession (2D-SSFP) or inversion-recovery gradient echo (2D-GRE) sequence...
June 2015: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Marian Christoph, Carsten Wunderlich, Stefanie Moebius, Mathias Forkmann, Judith Sitzy, Jozef Salmas, Julia Mayer, Yan Huo, Christopher Piorkowski, Thomas Gaspar
AIMS: Despite the use of established 3D-mapping systems, invasive electrophysiological studies and catheter ablation require high radiation exposure of patients and medical staff. This study investigated whether electroanatomic catheter tracking in prerecorded X-ray images on top of an existing 3D-mapping system has any impact on radiation exposure. METHODS AND RESULTS: Two hundred and ninety-five consecutive patients were either ablated with the guidance of the traditional CARTO-3 system (c3) or with help of the CARTO-UNIVU system (cU): [typical atrial flutter (AFL) n = 58, drug refractory atrial fibrillation (AF) n = 81, ectopic atrial tachycardia (EAT) n = 37, accessory pathways (APs) n = 22, symptomatic, idiopathic premature ventricular complexes (PVCs) n = 56, ventricular tachycardias (VTs) n = 41]...
June 2015: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Kelvin C Lau, Tammy L Sweeten, Maully J Shah
No abstract text is available yet for this article.
June 2015: Journal of Cardiovascular Electrophysiology
Robert Lemery, Mark Cleland, Jordan Bernick, George A Wells
AIMS: The intrinsic cardiac nervous system consists of ganglionated plexuses (GPs) localized epicardially to specific regions of the left atrium (LA). The relation between voltage thresholds and endocardial contact force associated with autonomic effects during stimulation of GPs has not previously been evaluated. METHODS AND RESULTS: Sixteen patients with symptomatic atrial fibrillation (AF) underwent mapping of GPs prior to radiofrequency ablation of AF. Pre-acquired computed tomographic images were merged with 3D non-fluoroscopic electroanatomic mapping of the LA...
April 2015: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Yoshikazu Watanabe, Yukiko Nakano, Takayuki Hidaka, Noboru Oda, Kenta Kajihara, Takehito Tokuyama, Yuko Uchimura, Akinori Sairaku, Chikaaki Motoda, Mai Fujiwara, Hiroshi Kawazoe, Hiroya Matsumura, Yasuki Kihara
BACKGROUND: Left atrial (LA) remodeling progresses to electrical remodeling, contractile remodeling, and subsequently structural remodeling. Little is known about the relationship between LA electrical and anatomical remodeling and LA mechanical function. OBJECTIVES: We aimed to clarify the relationship between LA mechanical function using 3-dimensional speckle-tracking echocardiography (3D-STE) and LA electrical remodeling using an electroanatomic mapping system (CARTO 3) and to estimate atrial fibrillation (AF) substrate in patients with paroxysmal AF (PAF)...
March 2015: Heart Rhythm: the Official Journal of the Heart Rhythm Society
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