Image-Integration of Intraprocedural Rotational Angiography-Based 3D Reconstructions of Left Atrium and Pulmonary Veins into Electroanatomical Mapping: Accuracy of a Novel Modality in Atrial Fibrillation Ablation

摘要

DynaCT Cardiac Integration into Electroanatomical Mapping. Introduction: Exact visualization of complex left atrial (LA) anatomy is crucial for safety and success rates when performing catheter ablation of atrial fibrillation (AF). The aim of our study was to validate the accuracy of integrating rotational angiography-based 3-dimensional (3D) reconstructions of LA and pulmonary vein (PV) anatomy into an electroanatomical mapping (EAM) system.Methods and Results: In 38 patients (62 +- 8 years, 25 females) undergoing catheter ablation of paroxysmal (n = 19) or persistent (n = 19) AF, intraprocedural rotational angiography of LA and PVs was performed. The subsequent 3D reconstruction and segmentation of LA and PVs was transferred to the EAM system and registered to the EAM. The dist ances of all EAM points to corresponding points on the LA syngo~RDynaCT Cardiac surface were calculated.Segmentation of LA with clear visualization of adjacent structures was possible in all patients. Also, the integrated segmentation of the LA was used to guide the encirclement of ipsilateral veins, which resulted in PV isolation in all patients. Integration into the 3D mapping system was achieved with a distance error of 2.2 +- 0.4 mm when compared with the EAM surface. Subgroups with paroxysmal and persistent AF showed distance errors of 2.3 +- 0.3 mm and 2.1 +- 0.4 mm, respectively (P = n.s.).