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The Accuracy and Clinical Applicability of a Sensor Based Electromagnetic Non-fluoroscopic Catheter Tracking System
년도 2019년 1월
카테고리 이달의 kcj Hot Article
저자 Shinya Yamada, MD,1,2,* Li-Wei Lo, MD,1,3,* Yenn-Jiang Lin, MD,1,3 Shih-Lin Chang, MD,1,3 Fa-Po Chung, MD,1,3 Yu-Feng Hu, MD,1,3 Ta-Chuan Tuan, MD,1,3 Tze-Fan Chao, MD,1,3 Jo-Nan Liao, MD,1,3 Chin-Yu Lin, MD,1 and Shih-Ann Chen, MD1,3
소속 1Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. 2Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan. 3Department of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.
첨부파일 1 kcj-49-e1-g003.jpg
첨부파일 2 kcj-49-e1-g003-.jpg
  • 관리자
  • 등록일 : 2019.01.07
  • Hit 565
Background and Objectives

The differences between electromagnetic-based mapping (EM) and impedance-based mapping (IM) in 3D anatomical reconstruction have not been fully clarified. We aimed to investigate the anatomical accuracy between EM (MediGuide™) and IM (EnSite Velocity™) systems.

Methods

We investigated 15 consecutive patients (10 males, mean age 58±9 years) who underwent pulmonary veins (PVs) isolation for paroxysmal atrial fibrillation (PAF). Contrast-enhanced computed tomography (CT) image of the left atrium (LA) was acquired before ablation and the 3D geometry of the LA was constructed using EM during ablation procedure. We measured the 4 PV angles between the main trunk of each PV and the posterior LA after field scaling. Additionally, the posterior LA surface area was measured. The variables were compared to those of CT-based geometry. A control group of 40 patients who underwent conventional PVs isolation using IM were also evaluated.

Results

The actual and relative changes of EM and CT-based geometry in all PV angles and posterior LA were significantly smaller compared to those of IM and CT-based geometry. Intraclass correlation coefficient (ICC) between EM and CT-based geometry were 0.871 (right superior pulmonary vein [RSPV]), 0.887 (right inferior pulmonary vein [RIPV]), 0.853 (left superior pulmonary vein [LSPV]), 0.911 (left inferior pulmonary vein [LIPV]), and 0.833 (posterior LA). On the other hand, ICC between IM and CT-based geometry were 0.548 (RSPV), 0.639 (RIPV), 0.691 (LSPV), 0.706 (LIPV), and 0.568 (posterior LA).

Conclusions

Image integration with EM enables high accurate visualization of cardiac anatomy compared to IM in PAF ablation.

Keywords:
Atrial fibrillationAtrial flutterAnatomyCardiovascular imagingFluoroscopy


원문보기 : https://www.e-kcj.org/DOIx.php?id=10.4070/kcj.2018.0195 

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