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Cardiac Electroanatomical 3D Mapping

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
Michela Casella, Corrado Carbucicchio, Eleonora Russo, Francesca Pizzamiglio, Paolo Golia, Sergio Conti, Fabrizio Costa, Antonio Dello Russo, Claudio Tondo
We report the case of a 63-year-old woman affected by a severe form of systemic scleroderma with pulmonary involvement (interstitial fibrosis diagnosed by biopsy and moderate pulmonary hypertension) and cardiac involvement (paroxysmal atrial fibrillation, right atrial flutter treated by catheter ablation, ventricular tachyarrhythmias, previous dual chamber implantable cardioverter defibrillator implant). Because of recurrent electrical storms refractory to iv antiarrhythmic drugs the patient was referred to our institution to undergo catheter ablation...
October 26, 2014: World Journal of Cardiology
Joachim Hebe, Jan-Hendrik Nürnberg, Klaus Langes
In children and adolescents with congenital heart disease (CHD) tachyarrhythmia occurs more frequently compared to patients with otherwise normal hearts. Arrhythmia substrates may be a natural part of certain congenital cardiac malformations or may result from long lasting myocardial deterioration as a result of CHD and/or cardiac surgery. Treatment of tachycardia is more frequently required even in early childhood, as the impact on quality of life, morbidity and mortality is higher due to an often reduced hemodynamic tolerance...
September 2014: Herzschrittmachertherapie & Elektrophysiologie
Zdeněk Stárek, František Lehar, Jiří Jež, Jiří Wolf, Miroslav Novák
Cardiac arrhythmias are a very frequent illness. Pharmacotherapy is not very effective in persistent arrhythmias and brings along a number of risks. Catheter ablation has became an effective and curative treatment method over the past 20 years. To support complex arrhythmia ablations, the 3D X-ray cardiac cavities imaging is used, most frequently the 3D reconstruction of CT images. The 3D cardiac rotational angiography (3DRA) represents a modern method enabling to create CT like 3D images on a standard X-ray machine equipped with special software...
October 2014: International Journal of Cardiovascular Imaging
John D Groarke, Alfonso H Waller, Tomas S Vita, Gregory F Michaud, Marcelo F Di Carli, Ron Blankstein, Raymond Y Kwong, Michael Steigner
BACKGROUND: We aimed to assess the feasibility of 3 dimensional (3D) respiratory and ECG gated, gadolinium enhanced magnetic resonance angiography (MRA) on a 3 Tesla (3 T) scanner for imaging pulmonary veins (PV) and left atrium (LA). The impact of heart rate (HR) and rhythm irregularity associated with atrial fibrillation (AF) on image and segmentation qualities were also assessed. METHODS: 101 consecutive patients underwent respiratory and ECG gated (ventricular end systolic window) MRA for pre AF ablation imaging...
2014: Journal of Cardiovascular Magnetic Resonance
Jayasree Pillarisetti, Arun Kanmanthareddy, Yeruva Madhu Reddy, Dhanunjaya Lakkireddy
Since the introduction of percutaneous intervention in modern medical science, specifically cardiovascular medicine fluoroscopy has remained the gold standard for navigation inside the cardiac structures. As the complexity of the procedures continue to increase with advances in interventional electrophysiology, the procedural times and fluoroscopy times have proportionately increased and the risks of radiation exposure both to the patients as well as the operator continue to rise. 3D electroanatomic mapping systems have to some extent complemented fluoroscopic imaging in improving catheter navigation and forming a solid platform for exploring the electroanatomic details of the target substrate...
September 2014: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Sebastian Stec, Janusz Sledź, Mariusz Mazij, Małgorzata Raś, Bartosz Ludwik, Michał Chrabąszcz, Arkadiusz Sledź, Małgorzata Banasik, Magdalena Bzymek, Krzysztof Młynarczyk, Karol Deutsch, Michał Labus, Jerzy Spikowski, Lesław Szydłowski
INTRODUCTION: Although the "near-zero-X-Ray" or "No-X-Ray" catheter ablation (CA) approach has been reported for treatment of various arrhythmias, few prospective studies have strictly used "No-X-Ray," simplified 2-catheter approaches for CA in patients with supraventricular tachycardia (SVT). We assessed the feasibility of a minimally invasive, nonfluoroscopic (MINI) CA approach in such patients. METHODS: Data were obtained from a prospective multicenter CA registry of patients with regular SVTs...
August 2014: Journal of Cardiovascular Electrophysiology
Rashed Karim, YingLiang Ma, Munjung Jang, R James Housden, Steven E Williams, Zhong Chen, Asghar Ataollahi, Kaspar Althoefer, C Aldo Rinaldi, Reza Razavi, Mark D O'Neill, Tobias Schaeftter, Kawal S Rhode
Surface flattening in medical imaging has seen widespread use in neurology and more recently in cardiology to describe the left ventricle using the bull's-eye plot. The method is particularly useful to standardize the display of functional information derived from medical imaging and catheter-based measurements. We hypothesized that a similar approach could be possible for the more complex shape of the left atrium (LA) and that the surface flattening could be useful for the management of patients with atrial fibrillation (AF)...
June 2014: Computerized Medical Imaging and Graphics: the Official Journal of the Computerized Medical Imaging Society
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