BACKGROUND: Estimation of the 3-dimensional (3D) position of ablation electrodes from fluoroscopic images is inadequate if a systematic lesion pattern is required in the treatment of complex arrhythmogenic substrates. METHODS AND RESULTS: We developed a new technique for online 3D localization of intracardiac electrodes. Regular catheter electrodes are used as sensors for a high-frequency transthoracic electrical field, which is applied via standard skin electrodes. We investigated localization accuracy within the right atrium, right ventricle, and left ventricle by comparing measured and true interelectrode distances of a decapolar catheter. Long-term stability was analyzed by localization of the most proximal His bundle before and after slow pathway ablation. Electrogram recordings were unaffected by the applied electrical field. Localization data from 3 catheter positions, widely distributed within the right atrium, right ventricle, or left ventricle, were analyzed in 10 patients per group. The relationship between measured and true electrode positions was highly linear, with an average correlation coefficient of 0.996, 0.997, and 0.999 for the right atrium, right ventricle, and left ventricle, respectively. Localization accuracy was better than 2 mm, with an additional scaling error of 8% to 14%. After 2 hours, localization of the proximal His bundle was reproducible within 1.4+/-1.1 mm. CONCLUSIONS: This new technique enables accurate and reproducible real-time localization of electrode positions in cardiac mapping and ablation procedures. Its application does not distort the quality of electrograms and can be applied to any electrode catheter.
BACKGROUND: Estimation of the 3-dimensional (3D) position of ablation electrodes from fluoroscopic images is inadequate if a systematic lesion pattern is required in the treatment of complex arrhythmogenic substrates. METHODS AND RESULTS: We developed a new technique for online 3D localization of intracardiac electrodes. Regular catheter electrodes are used as sensors for a high-frequency transthoracic electrical field, which is applied via standard skin electrodes. We investigated localization accuracy within the right atrium, right ventricle, and left ventricle by comparing measured and true interelectrode distances of a decapolar catheter. Long-term stability was analyzed by localization of the most proximal His bundle before and after slow pathway ablation. Electrogram recordings were unaffected by the applied electrical field. Localization data from 3 catheter positions, widely distributed within the right atrium, right ventricle, or left ventricle, were analyzed in 10 patients per group. The relationship between measured and true electrode positions was highly linear, with an average correlation coefficient of 0.996, 0.997, and 0.999 for the right atrium, right ventricle, and left ventricle, respectively. Localization accuracy was better than 2 mm, with an additional scaling error of 8% to 14%. After 2 hours, localization of the proximal His bundle was reproducible within 1.4+/-1.1 mm. CONCLUSIONS: This new technique enables accurate and reproducible real-time localization of electrode positions in cardiac mapping and ablation procedures. Its application does not distort the quality of electrograms and can be applied to any electrode catheter.
Authors: Timm Dickfeld; Hugh Calkins; Menekhem Zviman; Glenn Meininger; Lars Lickfett; Ariel Roguin; Albert C Lardo; Ronald Berger; Henry Halperin; Stephen B Solomon Journal: J Interv Card Electrophysiol Date: 2004-10 Impact factor: 1.900
Authors: Mark A Wood; Paul J Christman; Richard K Shepard; Kenneth A Ellenbogen Journal: J Interv Card Electrophysiol Date: 2004-04 Impact factor: 1.900
Authors: Douglas N Stephens; Uyen T Truong; Amin Nikoozadeh; Omer Oralkan; Chi Hyung Seo; Jonathan Cannata; Aaron Dentinger; Kai Thomenius; Alan de la Rama; Tho Nguyen; Feng Lin; Pierre Khuri-Yakub; Aman Mahajan; Kalyanam Shivkumar; Matt O'Donnell; David J Sahn Journal: J Ultrasound Med Date: 2012-02 Impact factor: 2.153
Authors: Ehud J Schmidt; Zion T H Tse; Tobias R Reichlin; Gregory F Michaud; Ronald D Watkins; Kim Butts-Pauly; Raymond Y Kwong; William Stevenson; Jeffrey Schweitzer; Israel Byrd; Charles L Dumoulin Journal: Magn Reson Med Date: 2014-03 Impact factor: 4.668