Real-time mapping of a whole heart chamber using a novel sparse ultrasonic catheter array
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ORIGINAL ARTICLE
Real-time mapping of a whole heart chamber using a novel sparse ultrasonic catheter array Alon Baram1,2
· Hayit Greenspan1 · Zvi Freidman2
Received: 30 April 2020 / Accepted: 30 October 2020 © CARS 2020
Abstract Purpose Atrial fibrillation (AF), the most prevalent form of cardiac arrhythmia, afflicts millions worldwide. Here, we developed an imaging algorithm for the diagnosis and online guidance of radio-frequency ablation, which is currently the first line of treatment for AF and other arrhythmia. This requires the simultaneous mapping of the left atrium anatomy and the propagation of the electrical activation wave, and for some arrhythmia, within a single heartbeat. Methods We constructed a multi-frequency ultrasonic system consisting of 64 elements mounted on a spherical basket, operated in a synthetic aperture mode, that allows instant localization of thousands of points on the endocardial surface and yields a MRI-like geometric reconstruction. Results The system and surface localization algorithm were extensively tested and validated in a series of in silico and in vitro experiments. We report considerable improvement over traditional methods along with theoretical results that help refine the extracted shape. The results in left atrium-shaped silicon phantom were accurate to within 4 mm. Conclusions A novel catheter system consisting of a basket of splines with multiple multi-frequency ultrasonic elements allows 3D anatomical mapping and real-time tracking of the entire heart chamber within a single heartbeat. These design parameters achieve highly acceptable reconstruction accuracy. Keywords Heart chamber mapping · Intracardiac ultrasonic catheter · Ultrasonic imaging · Atrial fibrillation · Distributed array
Introduction Atrial fibrillation (AF) currently affects 2.3 to 5.1 million people in the USA alone. These numbers are expected to grow to some 5.6 to 12.1 million by 2050 [5]. In most cases, this arrhythmia originates in the pulmonary veins. Electroanatomical mapping-guided radio-frequency (RF) ablation is a widespread treatment for arrhythmia [5]. In AF, the This paper is based on the work: Baram A, Greenspan H, Friedman Z. In: Shen D. et al. (eds) Medical Image Computing and Computer Assisted Intervention—MICCAI 2019. MICCAI 2019. Lecture Notes in Computer Science, vol 11768. Springer, Cham.
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Alon Baram [email protected]
1
Medical Image Processing Laboratory, Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, 69978 Tel Aviv, Israel
2
Biosense Webster (Israel), Ltd, 4 Hatnufa Street, 20692 Yokneam, Israel
procedure involves percutaneous insertion of catheters into the heart and then generating transmyocardial lesions at the pulmonary venal ostia, thus blocking all signals originating from the veins. Ablation procedures require high precision three-dimensional mapping and guidance provided by electro-anatomic systems such as the CARTO® 3 System. During the catheter’s traversal of the heart’s chamber, a point-by-point sampling of the endocar
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