Fluoroscopic navigation to guide RF catheter ablation of cardiac arrhythmias.

摘要

Severe disorders of the cardiac rhythm that can cause syncope or sudden cardiac death can be treated by radio-frequency (RF) catheter ablation. The precise localization of the arrhythmogenic site and the positioning of the RF catheter over that site are problematic as they impair the efficiency of the procedure and are time consuming.;Our group is attempting to develop a more affordable fluoroscopic navigation system. Preliminary results have shown that it is possible to effectively superimpose over a fluoroscopic X-ray image of the heart, an isochronal map depicting the cardiac electrical activation sequence that is generated from geometrical data obtained from fluoroscopic images of the catheters. The main objective of this work has been to continue perfecting our three-dimensional mapping system using data obtained from an animal experiment.;An innovative approach for the fusion of isochronal maps with fluoroscopic images that uses standard catheters and instrumentation was developed. When 3D data was obtained from two projections, appropriate maps that well represented the progression of the electrical activation were generated. When 3D data was obtained from a single image, the standard error of the electrode depth estimate was too large for a precise reconstruction of the cardiac chambers. Better image processing techniques remain to be developed to extract 3D information from a single fluoroscopic image. (Abstract shortened by UMI.).