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Intracardiac Echocardiography during Catheter-Based Ablation of Atrial Fibrillation.

Biermann J, Bode C, Asbach S - Cardiol Res Pract (2012)

Bottom Line: Software algorithms like CARTOSound (Biosense Webster, Diamond Bar, USA) offer the opportunity to reconstruct multiple two-dimensional ultrasound fans generated by intracardiac echocardiography to a three-dimensional object which can be merged to a computed tomography or magnetic resonance imaging reconstruction of the left atrium.Intracardiac ultrasound reduces dwell time of catheters in the left atrium, fluoroscopy, and procedural time and is invaluable concerning early identification of potential adverse events.The application of intracardiac echocardiography has the great capability to improve success rates of catheter-based ablation procedures.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology and Angiology, University Hospital of Freiburg, Hugstetter Stra β e 55, 79106 Freiburg, Germany.

ABSTRACT
Accurate delineation of the variable left atrial anatomy is of utmost importance during anatomically based ablation procedures for atrial fibrillation targeting the pulmonary veins and possibly other structures of the atria. Intracardiac echocardiography allows real-time visualisation of the left atrium and adjacent structures and thus facilitates precise guidance of catheter-based ablation of atrial fibrillation. In patients with abnormal anatomy of the atria and/or the interatrial septum, intracardiac ultrasound might be especially valuable to guide transseptal access. Software algorithms like CARTOSound (Biosense Webster, Diamond Bar, USA) offer the opportunity to reconstruct multiple two-dimensional ultrasound fans generated by intracardiac echocardiography to a three-dimensional object which can be merged to a computed tomography or magnetic resonance imaging reconstruction of the left atrium. Intracardiac ultrasound reduces dwell time of catheters in the left atrium, fluoroscopy, and procedural time and is invaluable concerning early identification of potential adverse events. The application of intracardiac echocardiography has the great capability to improve success rates of catheter-based ablation procedures.

No MeSH data available.


Related in: MedlinePlus

Reconstruction of left pulmonary veins (a and b) and right pulmonary veins (c and d) using ICE in combination with the integrated software algorithm CARTOMerge. A dedicated ICE probe provides real-time anatomic images that are integrated with preprocedural acquired CT images. On ECG-gated ICE images, the anatomy of the PVs can be annotated (a and c), creating a 3D shell, and subsequently is integrated with the dedicated algorithm (b and d).
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fig3: Reconstruction of left pulmonary veins (a and b) and right pulmonary veins (c and d) using ICE in combination with the integrated software algorithm CARTOMerge. A dedicated ICE probe provides real-time anatomic images that are integrated with preprocedural acquired CT images. On ECG-gated ICE images, the anatomy of the PVs can be annotated (a and c), creating a 3D shell, and subsequently is integrated with the dedicated algorithm (b and d).

Mentions: The endocardial surface of the LA and its adjacent structures are traced in multiple ICE images creating several ICE fans of left atrial body, left atrial appendage, LSPV, LIPV, RSPV, and RIPV (Figure 3). The resulting 3D image of the LA can then be merged to a 3D CT or MRI reconstruction of the LA (Figure 4) using an integrated software algorithm (CARTOMerge, Biosense Webster, Diamond Bar, USA). Recording of only three ultrasound fans seems to be sufficient to exactly register the surface to a preprocedurally recorded CT or MRI [41]. The ablation procedure is subsequently guided by visualisation of the ablation catheter within the merged image, by intermittent fluoroscopy and continuous monitoring with ICE. Since ICE mapping can be performed from the right atrium, this approach involves shorter prothrombotic dwell time of catheters in the LA. Navigation of catheters is easier with potentially less fluoroscopy time [19, 41]. Intracardiac ultrasound integration into 3D electroanatomic reconstruction of the LA provides reliable guidance for PV isolation.


Intracardiac Echocardiography during Catheter-Based Ablation of Atrial Fibrillation.

Biermann J, Bode C, Asbach S - Cardiol Res Pract (2012)

Reconstruction of left pulmonary veins (a and b) and right pulmonary veins (c and d) using ICE in combination with the integrated software algorithm CARTOMerge. A dedicated ICE probe provides real-time anatomic images that are integrated with preprocedural acquired CT images. On ECG-gated ICE images, the anatomy of the PVs can be annotated (a and c), creating a 3D shell, and subsequently is integrated with the dedicated algorithm (b and d).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3368317&req=5

fig3: Reconstruction of left pulmonary veins (a and b) and right pulmonary veins (c and d) using ICE in combination with the integrated software algorithm CARTOMerge. A dedicated ICE probe provides real-time anatomic images that are integrated with preprocedural acquired CT images. On ECG-gated ICE images, the anatomy of the PVs can be annotated (a and c), creating a 3D shell, and subsequently is integrated with the dedicated algorithm (b and d).
Mentions: The endocardial surface of the LA and its adjacent structures are traced in multiple ICE images creating several ICE fans of left atrial body, left atrial appendage, LSPV, LIPV, RSPV, and RIPV (Figure 3). The resulting 3D image of the LA can then be merged to a 3D CT or MRI reconstruction of the LA (Figure 4) using an integrated software algorithm (CARTOMerge, Biosense Webster, Diamond Bar, USA). Recording of only three ultrasound fans seems to be sufficient to exactly register the surface to a preprocedurally recorded CT or MRI [41]. The ablation procedure is subsequently guided by visualisation of the ablation catheter within the merged image, by intermittent fluoroscopy and continuous monitoring with ICE. Since ICE mapping can be performed from the right atrium, this approach involves shorter prothrombotic dwell time of catheters in the LA. Navigation of catheters is easier with potentially less fluoroscopy time [19, 41]. Intracardiac ultrasound integration into 3D electroanatomic reconstruction of the LA provides reliable guidance for PV isolation.

Bottom Line: Software algorithms like CARTOSound (Biosense Webster, Diamond Bar, USA) offer the opportunity to reconstruct multiple two-dimensional ultrasound fans generated by intracardiac echocardiography to a three-dimensional object which can be merged to a computed tomography or magnetic resonance imaging reconstruction of the left atrium.Intracardiac ultrasound reduces dwell time of catheters in the left atrium, fluoroscopy, and procedural time and is invaluable concerning early identification of potential adverse events.The application of intracardiac echocardiography has the great capability to improve success rates of catheter-based ablation procedures.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology and Angiology, University Hospital of Freiburg, Hugstetter Stra β e 55, 79106 Freiburg, Germany.

ABSTRACT
Accurate delineation of the variable left atrial anatomy is of utmost importance during anatomically based ablation procedures for atrial fibrillation targeting the pulmonary veins and possibly other structures of the atria. Intracardiac echocardiography allows real-time visualisation of the left atrium and adjacent structures and thus facilitates precise guidance of catheter-based ablation of atrial fibrillation. In patients with abnormal anatomy of the atria and/or the interatrial septum, intracardiac ultrasound might be especially valuable to guide transseptal access. Software algorithms like CARTOSound (Biosense Webster, Diamond Bar, USA) offer the opportunity to reconstruct multiple two-dimensional ultrasound fans generated by intracardiac echocardiography to a three-dimensional object which can be merged to a computed tomography or magnetic resonance imaging reconstruction of the left atrium. Intracardiac ultrasound reduces dwell time of catheters in the left atrium, fluoroscopy, and procedural time and is invaluable concerning early identification of potential adverse events. The application of intracardiac echocardiography has the great capability to improve success rates of catheter-based ablation procedures.

No MeSH data available.


Related in: MedlinePlus