Real-time cardiac catheter navigation on three-dimensional CT images

Area of Science:

• Cardiovascular Imaging
• Electrophysiology
• Medical Device Technology

Background:

• Cardiac ablation procedures increasingly rely on precise anatomic targeting.
• Fluoroscopy's limitations in visualizing catheter-cardiac structure relationships and radiation risks necessitate improved mapping methods.

Purpose of the Study:

• To evaluate the feasibility and accuracy of real-time catheter navigation guided by three-dimensional (3D) computed tomography (CT) in swine.
• To assess the potential of this integrated imaging approach for improving anatomically guided cardiac interventions.

Main Methods:

• Electromagnetic catheter tip position data was superimposed onto 3D CT chest scans in swine.
• Fiducial markers facilitated image registration for accurate overlay.
• Real-time display of catheter position and orientation guided navigation within cardiac structures.

Main Results:

• Anatomic landmarks including the atrial septum, pulmonary veins, and valves were readily identified for navigation.
• Successful catheter navigation was achieved in the right and left heart chambers and great vessels.
• The novel mapping approach demonstrated high accuracy (4.69 ± 1.70 mm) and precision (2.22 ± 0.69 mm) without complications.

Conclusions:

• Real-time catheter navigation on 3D CT scans provides accurate and precise guidance within the heart.
• This detailed anatomic information can enhance procedures like pulmonary vein ablation.
• The technique holds potential for reducing fluoroscopy time and radiation exposure in cardiac interventions.