Segmentation and registration of three-dimensional rotational angiogram on live fluoroscopy to guide atrial fibrillation ablation: A new online imaging tool

Jonathan H. Li; Moti Haim; Babak Movassaghi; Jeffrey B. Mendel; G. Muqtada Chaudhry; Charles I. Haffajee; Michael V. Orlov

doi:10.1016/j.hrthm.2008.10.038

Segmentation and registration of three-dimensional rotational angiogram on live fluoroscopy to guide atrial fibrillation ablation: A new online imaging tool

Jonathan H. Li, Moti Haim, Babak Movassaghi, Jeffrey B. Mendel, G. Muqtada Chaudhry, Charles I. Haffajee, Michael V. Orlov

Research output: Contribution to journal › Article › peer-review

77 Scopus citations

Abstract

Background: Three-dimensional rotational atriography (3DATG) was developed to supplement two-dimensional fluoroscopy with 3D volume reconstruction of the left atrium (LA), pulmonary veins (PV), and other structures. Until recently, 3DATG images could only be viewed separately and were not suitable to directly guide atrial fibrillation (AF) ablation. Objective: The purpose of this study was to evaluate the feasibility and accuracy of intraprocedural 3DATG. Methods: Three-dimensional rotational atriography with right atrial contrast injection was obtained using a Philips Allura Xper FD10 system in 30 patients with symptomatic AF who also underwent preprocedural computed tomographic (CT) scan. Results: The majority (93%) of 3DATG image reconstructions were useful for guidance of catheter ablation. Nearly all PVs (94%), LA appendage (89%), and esophagus (100%) were successfully segmented. Measured PV ostial diameters compared using 3DATG and CT showed close concordance. Registration and re-registration of 3DATG overlay image was easily achieved with thoracic landmarks and validated by catheter placement demonstrating minimal discrepancy. Endoscopic views allowed for improved visualization of ostial position, dimensions, and navigation within the antrum. Lesion tagging on 3DATG overlay enhanced ablation guidance. Radiation exposure with 3DATG was significantly reduced compared with preprocedural CT scan (2.1 ± 0.3 mSv vs 13.8 ± 2.4 mSv, P <.001). Conclusion: Intraprocedural 3DATG imaging during AF ablation with online segmentation and superimposition on live fluoroscopy is feasible. Overlay provides valuable and accurate information on 3D surface outline and endoscopic PV location. Three-dimensional rotational atriography overlay is a new imaging method with reduced radiation exposure that may replace preprocedural CT scan for catheter navigation and ablation of AF.

Original language	English
Pages (from-to)	231-237
Number of pages	7
Journal	Heart Rhythm
Volume	6
Issue number	2
DOIs	https://doi.org/10.1016/j.hrthm.2008.10.038
State	Published - 1 Feb 2009
Externally published	Yes

Keywords

Ablation
Atrium
Fibrillation
Imaging

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine
Physiology (medical)

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.hrthm.2008.10.038

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@article{da7efe6627914217b696e531edc6c447,

title = "Segmentation and registration of three-dimensional rotational angiogram on live fluoroscopy to guide atrial fibrillation ablation: A new online imaging tool",

abstract = "Background: Three-dimensional rotational atriography (3DATG) was developed to supplement two-dimensional fluoroscopy with 3D volume reconstruction of the left atrium (LA), pulmonary veins (PV), and other structures. Until recently, 3DATG images could only be viewed separately and were not suitable to directly guide atrial fibrillation (AF) ablation. Objective: The purpose of this study was to evaluate the feasibility and accuracy of intraprocedural 3DATG. Methods: Three-dimensional rotational atriography with right atrial contrast injection was obtained using a Philips Allura Xper FD10 system in 30 patients with symptomatic AF who also underwent preprocedural computed tomographic (CT) scan. Results: The majority (93%) of 3DATG image reconstructions were useful for guidance of catheter ablation. Nearly all PVs (94%), LA appendage (89%), and esophagus (100%) were successfully segmented. Measured PV ostial diameters compared using 3DATG and CT showed close concordance. Registration and re-registration of 3DATG overlay image was easily achieved with thoracic landmarks and validated by catheter placement demonstrating minimal discrepancy. Endoscopic views allowed for improved visualization of ostial position, dimensions, and navigation within the antrum. Lesion tagging on 3DATG overlay enhanced ablation guidance. Radiation exposure with 3DATG was significantly reduced compared with preprocedural CT scan (2.1 ± 0.3 mSv vs 13.8 ± 2.4 mSv, P <.001). Conclusion: Intraprocedural 3DATG imaging during AF ablation with online segmentation and superimposition on live fluoroscopy is feasible. Overlay provides valuable and accurate information on 3D surface outline and endoscopic PV location. Three-dimensional rotational atriography overlay is a new imaging method with reduced radiation exposure that may replace preprocedural CT scan for catheter navigation and ablation of AF.",

keywords = "Ablation, Atrium, Fibrillation, Imaging",

author = "Li, {Jonathan H.} and Moti Haim and Babak Movassaghi and Mendel, {Jeffrey B.} and Chaudhry, {G. Muqtada} and Haffajee, {Charles I.} and Orlov, {Michael V.}",

note = "Funding Information: Dr. Jonathan Li is supported by a research grant from Philips Healthcare. Dr. Babak Movassaghi is employed by Philips Healthcare North America. Dr. Michael Orlov has received honoraria from Philips Healthcare and has been a consultant for the company. ",

year = "2009",

month = feb,

day = "1",

doi = "10.1016/j.hrthm.2008.10.038",

language = "English",

volume = "6",

pages = "231--237",

journal = "Heart Rhythm",

issn = "1547-5271",

publisher = "Elsevier B.V.",

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TY - JOUR

T1 - Segmentation and registration of three-dimensional rotational angiogram on live fluoroscopy to guide atrial fibrillation ablation

T2 - A new online imaging tool

AU - Li, Jonathan H.

AU - Haim, Moti

AU - Movassaghi, Babak

AU - Mendel, Jeffrey B.

AU - Chaudhry, G. Muqtada

AU - Haffajee, Charles I.

AU - Orlov, Michael V.

N1 - Funding Information: Dr. Jonathan Li is supported by a research grant from Philips Healthcare. Dr. Babak Movassaghi is employed by Philips Healthcare North America. Dr. Michael Orlov has received honoraria from Philips Healthcare and has been a consultant for the company.

PY - 2009/2/1

Y1 - 2009/2/1

N2 - Background: Three-dimensional rotational atriography (3DATG) was developed to supplement two-dimensional fluoroscopy with 3D volume reconstruction of the left atrium (LA), pulmonary veins (PV), and other structures. Until recently, 3DATG images could only be viewed separately and were not suitable to directly guide atrial fibrillation (AF) ablation. Objective: The purpose of this study was to evaluate the feasibility and accuracy of intraprocedural 3DATG. Methods: Three-dimensional rotational atriography with right atrial contrast injection was obtained using a Philips Allura Xper FD10 system in 30 patients with symptomatic AF who also underwent preprocedural computed tomographic (CT) scan. Results: The majority (93%) of 3DATG image reconstructions were useful for guidance of catheter ablation. Nearly all PVs (94%), LA appendage (89%), and esophagus (100%) were successfully segmented. Measured PV ostial diameters compared using 3DATG and CT showed close concordance. Registration and re-registration of 3DATG overlay image was easily achieved with thoracic landmarks and validated by catheter placement demonstrating minimal discrepancy. Endoscopic views allowed for improved visualization of ostial position, dimensions, and navigation within the antrum. Lesion tagging on 3DATG overlay enhanced ablation guidance. Radiation exposure with 3DATG was significantly reduced compared with preprocedural CT scan (2.1 ± 0.3 mSv vs 13.8 ± 2.4 mSv, P <.001). Conclusion: Intraprocedural 3DATG imaging during AF ablation with online segmentation and superimposition on live fluoroscopy is feasible. Overlay provides valuable and accurate information on 3D surface outline and endoscopic PV location. Three-dimensional rotational atriography overlay is a new imaging method with reduced radiation exposure that may replace preprocedural CT scan for catheter navigation and ablation of AF.

AB - Background: Three-dimensional rotational atriography (3DATG) was developed to supplement two-dimensional fluoroscopy with 3D volume reconstruction of the left atrium (LA), pulmonary veins (PV), and other structures. Until recently, 3DATG images could only be viewed separately and were not suitable to directly guide atrial fibrillation (AF) ablation. Objective: The purpose of this study was to evaluate the feasibility and accuracy of intraprocedural 3DATG. Methods: Three-dimensional rotational atriography with right atrial contrast injection was obtained using a Philips Allura Xper FD10 system in 30 patients with symptomatic AF who also underwent preprocedural computed tomographic (CT) scan. Results: The majority (93%) of 3DATG image reconstructions were useful for guidance of catheter ablation. Nearly all PVs (94%), LA appendage (89%), and esophagus (100%) were successfully segmented. Measured PV ostial diameters compared using 3DATG and CT showed close concordance. Registration and re-registration of 3DATG overlay image was easily achieved with thoracic landmarks and validated by catheter placement demonstrating minimal discrepancy. Endoscopic views allowed for improved visualization of ostial position, dimensions, and navigation within the antrum. Lesion tagging on 3DATG overlay enhanced ablation guidance. Radiation exposure with 3DATG was significantly reduced compared with preprocedural CT scan (2.1 ± 0.3 mSv vs 13.8 ± 2.4 mSv, P <.001). Conclusion: Intraprocedural 3DATG imaging during AF ablation with online segmentation and superimposition on live fluoroscopy is feasible. Overlay provides valuable and accurate information on 3D surface outline and endoscopic PV location. Three-dimensional rotational atriography overlay is a new imaging method with reduced radiation exposure that may replace preprocedural CT scan for catheter navigation and ablation of AF.

KW - Ablation

KW - Atrium

KW - Fibrillation

KW - Imaging

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U2 - 10.1016/j.hrthm.2008.10.038

DO - 10.1016/j.hrthm.2008.10.038

M3 - Article

AN - SCOPUS:58949092780

SN - 1547-5271

VL - 6

SP - 231

EP - 237

JO - Heart Rhythm

JF - Heart Rhythm

IS - 2

ER -

Segmentation and registration of three-dimensional rotational angiogram on live fluoroscopy to guide atrial fibrillation ablation: A new online imaging tool

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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