Cryoballoon ablation for atrial fibrillation guided by real-time three-dimensional transoesophageal echocardiography: a feasibility study

Ottaviano, Luca; Chierchia, Gian Battista; Bregasi, Alda; Bruno, Nicola; Antonelli, Andrea; Alsheraei, Ali; Porrini, A.M.; Gronda, Edoardo; Donatelli, Francesco; Duijnhower, Anthonie Leendert; Brugada, Pedro; Montenero, A. S.

doi:10.1093/europace/eus431

Cited by 23 publications

(16 citation statements)

References 27 publications

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“…Considering most complications are nearly all caused by incorrect puncture site (13), TEE can provide more benefit even when using biplane fluoroscopy. TEE not only 3D TEE allows real-time visualization of pulmonary vein anatomy, as well as of all surrounding atrial structures (14). It permits online monitoring of balloon positioning and pulmonary vein occlusion via color Doppler, which guides the operator to perform every step of the procedure in a safe manner and might improve both safety and efficacy of the procedure.…”

Section: Discussionmentioning

confidence: 99%

Profuse and acute hemorrhagic gastroesophageal injury after cryotherapy in a cardiac surgery patient

Kim

Lee

et al. 2017

J. Thorac. Dis.

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Upper gastrointestinal injury associated with cryoablation and under placement of transesophageal echocardiography (TEE) during cardiac surgery is a rare complication but potentially fatal.During the cryoablation for the treatment of atrial fibrillation, delivered cryoenergy can adversely affect the esophagus, resulting in gastroesophageal ulceration. The TEE probe itself also can induce adverse effects like esophageal ulceration or perforation. In this case report, we describe a case of emergent gastroesophageal injury with massive bleeding that occurred after manipulation of a TEE probe during cryoablation therapy in a cardiac surgery patient.

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Section: Discussionmentioning

confidence: 99%

Profuse and acute hemorrhagic gastroesophageal injury after cryotherapy in a cardiac surgery patient

Kim

Lee

et al. 2017

J. Thorac. Dis.

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“…[44][45][46] It might also play a role in both surgical plans and ablation guidance, especially for the ventricular tachycardia and ventricular arrhythmia. 28,[47][48][49]…”

Section: Discussionmentioning

confidence: 99%

DTI template-based estimation of cardiac fiber orientations from 3D ultrasound

Qin

Fei

2015

Med. Phys.

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Purpose: Cardiac muscle fibers directly affect the mechanical, physiological, and pathological properties of the heart. Patient-specific quantification of cardiac fiber orientations is an important but difficult problem in cardiac imaging research. In this study, the authors proposed a cardiac fiber orientation estimation method based on three-dimensional (3D) ultrasound images and a cardiac fiber template that was obtained from magnetic resonance diffusion tensor imaging (DTI). Methods: A DTI template-based framework was developed to estimate cardiac fiber orientations from 3D ultrasound images using an animal model. It estimated the cardiac fiber orientations of the target heart by deforming the fiber orientations of the template heart, based on the deformation field of the registration between the ultrasound geometry of the target heart and the MRI geometry of the template heart. In the experiments, the animal hearts were imaged by high-frequency ultrasound, T1-weighted MRI, and high-resolution DTI. Results: The proposed method was evaluated by four different parameters: Dice similarity coefficient (DSC), target errors, acute angle error (AAE), and inclination angle error (IAE). Its ability of estimating cardiac fiber orientations was first validated by a public database. Then, the performance of the proposed method on 3D ultrasound data was evaluated by an acquired database. Their average values were 95.4% ± 2.0% for the DSC of geometric registrations, 21.0• ± 0.76• for AAE, and 19.4• ± 1.2• for IAE of fiber orientation estimations. Furthermore, the feasibility of this framework was also performed on 3D ultrasound images of a beating heart. Conclusions: The proposed framework demonstrated the feasibility of using 3D ultrasound imaging to estimate cardiac fiber orientation of in vivo beating hearts and its further improvements could contribute to understanding the dynamic mechanism of the beating heart and has the potential to help diagnosis and therapy of heart disease. C 2015 American Association of Physicists in Medicine.

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“…12.16) [109][110] [111]. Recently, RT3D TEE has been demonstrated in several clinical studies to provide superior 3D visualization of all pulmonary vein ostia and neighboring left atrial structures during ablation and to provide the operator successful guidance to position an ablation c atheter or cryoballoon in the pulmonary veins [112] [113] [114].…”

Section: Electrophysiological Proceduresmentioning

confidence: 99%