2100 Correlation of left atrial scar due to pulmonary vein ablation with recorded ablation sites
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Meeting abstract
2100 Correlation of left atrial scar due to pulmonary vein ablation with recorded ablation sites Jason E Taclas*1, John V Wylie1, Reza Nezafat1, Mark E Josephson1, Warren J Manning2 and Dana C Peters1 Address: 1Beth Israel Deaconess Medical Center, Dept. of Medicine, Boston, MA, USA and 2Beth Israel Deaconess Medical Center, Dept. of Medicine and Radiology, Boston, MA, USA * Corresponding author
from 11th Annual SCMR Scientific Sessions Los Angeles, CA, USA. 1–3 February 2008 Published: 22 October 2008 Journal of Cardiovascular Magnetic Resonance 2008, 10(Suppl 1):A369
doi:10.1186/1532-429X-10-S1-A369
Abstracts of the 11th Annual SCMR Scientific Sessions - 2008
Meeting abstracts – A single PDF containing all abstracts in this Supplement is available here. http://www.biomedcentral.com/content/pdf/1532-429X-10-S1-info.pdfThis abstract is available from: http://jcmr-online.com/content/10/S1/A369 © 2008 Taclas et al; licensee BioMed Central Ltd.
Introduction Radiofrequency (RF) pulmonary vein (PV) ablation (also known as PV isolation) is a catheter-based treatment for atrial fibrillation. The end-point of the RF ablation procedure at our institution is complete electrical block between the left atrium (LA) and the PV ostia. Some groups use an anatomically-guided ring of ablations around the PVs and LA as a surrogate end-point. At our institution, the CARTOMERGE system(Biosense-Webster, Diamond Bar, CA) is used to create a 3D map of the surface of the LA and PVs during the procedures. The map is then registered to previously acquired CT or MRI images and the resulting fused image is used to guide during the ablation procedure. During the procedure, points representing the LA surface and each RF ablation are recorded into CARTO data files. After the procedure, the scar generated by RF ablation [1] can be imaged using high spatial resolution delayed enhancement (DE) cardiovascular MR (CMR) [2]. In order to understand the relationship between the ablations performed and the scar pattern that results, we sought to develop a technique for fusing the CARTO data with the scar data from the MRI scan.
remove the aorta and the pulmonary arteries, since these structures obscure the visualization of the scar on the surface of the left atrium, and also reduce the quality of the registration of the angiogram to the CARTO surface. We have developed a software tool using Kitware's Visual Toolkit (VTK) and Insight Segmentation and Registration Toolkit (ITK) to register and display the data. The recorded ablation locations and LA surface points were fused with the MRA surface, using rigid registration (with the PV ostia as landmarks) followed by iterative closest point algorithm, as previously described [3,4]. Eight patients have been studied to date.
Results Comparison in one patient of the results of our custom fusion method with CARTOMERGE showed excellent agreement (Figure 1), showing the same relationship between the ablation locations and the PV ostia in both methods.
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