Advanced Mapping and Navigation Modalities

Issa, Ziad F.; Miller, John M.; Zipes, Douglas P.

doi:10.1016/b978-1-4557-1274-8.00006-3

Cited by 7 publications

(7 citation statements)

References 56 publications

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“…This phenomenon has been noted anecdotally and systematically described in one series . We present a practical guide to adjust for this spatial shift during PVC mapping and ablation procedures.…”

Section: Introductionmentioning

confidence: 65%

“…Magneticbased electroanatomic mapping tags the 3-dimensional (3D) location of a mapped point to the location of the mapping catheter in the spatially encoded magnetic field around the patient's chest instantaneously at the fiducial reference time, typically the peak/nadir of the QRS complex on the selected ECG lead. 3 It follows that a myocardial location mapped during a PVC may be spatially shifted relative to the location of the same tissue mapped in sinus rhythm ( Figure 1). This phenomenon has been noted anecdotally and systematically described in one series.…”

Section: Introductionmentioning

confidence: 98%

“…Catheter ablation of premature ventricular complexes (PVCs) is guided by electroanatomic mapping of ventricular chambers . Mapping the region of earliest activation during PVCs identifies the presumed site of origin and target for focal ablation . It is often necessary to deliver ablation lesions in the absence of clinical PVCs, guided by the activation map acquired beforehand during PVCs.…”

Section: Introductionmentioning

confidence: 99%

“…Presystolic ventricular geometry is likely to be dependent upon PVC timing during diastole and may be driven by incomplete ventricular relaxation after the preceding cycle, incomplete ventricular filling due to the absence of late diastolic atrial contraction, mechanical displacement of the ventricular chambers due to atrial contraction, or altered pattern of electrical activation during PVC. Magnetic‐based electroanatomic mapping tags the 3‐dimensional (3D) location of a mapped point to the location of the mapping catheter in the spatially encoded magnetic field around the patient's chest instantaneously at the fiducial reference time, typically the peak/nadir of the QRS complex on the selected ECG lead . It follows that a myocardial location mapped during a PVC may be spatially shifted relative to the location of the same tissue mapped in sinus rhythm (Figure ).…”

Section: Introductionmentioning

confidence: 99%

“…1 Mapping the region of earliest activation during PVCs identifies the presumed site of origin and target for focal ablation. 2,3 It is often necessary to deliver ablation lesions in the absence of clinical PVCs, guided by the activation map acquired beforehand during PVCs. This may be needed due to suppression of clinical PVCs during mapping or after initial ablation lesion delivery.…”

Section: Introductionmentioning

confidence: 99%

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Ablation using 3D maps adjusted for spatial displacement of premature ventricular complexes relative to sinus beats: Improving precision by correcting for the shift

Steyers

Sodhi

Faddis

et al. 2019

Cardiovasc electrophysiol

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Introduction Point‐by‐point 3‐dimensional (3D) electroanatomic mapping (EAM) is used to guide catheter ablation of premature ventricular complexes (PVCs). Due to the differences in the spatial excursion of the cardiac chambers during cardiac cycles in PVCs vs sinus rhythm, the 3D location registration during PVCs is shifted relative to sinus rhythm. In this study, we describe our strategy to adjust for this displacement in real‐time during PVC mapping. Methods and Results We report 21 patients who underwent catheter ablation of 23 unique PVCs using Carto 3. After mapping the earliest site for each PVC, we reregistered its 3D location to a sinus rhythm beat in real‐time, and used this to guide ablation lesion delivery. The PVC earliest location was spatially displaced from the successful ablation lesion in sinus rhythm by average 6.7 (range 3.3–13.0) mm. Offline, we subsequently analyzed 25 unique chamber maps and 606 PVC points. For each point, we reregistered the 3D location to a preceding sinus beat. The PVC points were displaced from sinus rhythm location by average 4.4 (0.3–13.7) mm. The maximally displaced point for each chamber was 7.7 (4.7–13.7) mm. The general direction of shift during PVC was leftward and inferior relative to sinus rhythm. Conclusions During electroanatomic mapping of PVCs using the Carto 3 system, points mapped during PVCs are spatially displaced relative to their location in sinus rhythm. Electrophysiologists should recognize this phenomenon and account for the shift to guide accurate delivery of ablation lesions.

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Section: Introductionmentioning

confidence: 65%

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Ablation using 3D maps adjusted for spatial displacement of premature ventricular complexes relative to sinus beats: Improving precision by correcting for the shift

Steyers

Sodhi

Faddis

et al. 2019

Cardiovasc electrophysiol

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Concepts and Trends in Autonomy for Robot-Assisted Surgery

et al. 2022

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An Automatic Registration Method for Radiation-Free Catheter Navigation Guidance

Gruijthuijsen

Rosa

Tran

et al. 2016

J. Med. Robot. Res.

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Catheter navigation is typically based on fluoroscopy. This implies exposure to harmful radiation, lack of depth perception and limited soft-tissue contrast. Catheter navigation would benefit from guidance that makes better use of detailed pre-operatively acquired MR/CT images, while reducing radiation exposure and improving spatial awareness of the catheter pose and shape. A prerequisite for such guidance is an accurate registration between the catheter tracking system and the MR/CT scans. Existing registration methods are lengthy and cumbersome as they require a lot of user interaction. This forms a major obstacle for their adoption into clinical practice. This paper proposes a radiation-free registration method that minimizes the impact on the surgical workflow and avoids most user interaction. The method relies on catheters with embedded sensors that provide intra-operative data that can either belong to the vessel wall or to the lumen of the vessel. Based on the acquired surface and lumen points an accurate registration is computed automatically, with minimal user interaction. Validation of the proposed method is performed on a synthetic yet realistic aorta phantom. Input from electromagnetic tracking, force sensing, and intra-vascular ultrasound are used as intra-operative sensory data.

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Advanced Mapping and Navigation Modalities

Cited by 7 publications

References 56 publications

Ablation using 3D maps adjusted for spatial displacement of premature ventricular complexes relative to sinus beats: Improving precision by correcting for the shift

Ablation using 3D maps adjusted for spatial displacement of premature ventricular complexes relative to sinus beats: Improving precision by correcting for the shift

Concepts and Trends in Autonomy for Robot-Assisted Surgery

An Automatic Registration Method for Radiation-Free Catheter Navigation Guidance

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