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Cardiac Imaging to Assist Complex Ablation Procedures

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Cardiac Arrhythmias

Abstract

The introduction of three-dimensional (3D) electroanatomical mapping into the clinical electrophysiology realm has led to the ability to properly diagnose and treat a wide variety of complex arrhythmias such as ventricular tachycardia and atrial fibrillation. 3D mapping allows for reconstruction of heart models providing detailed anatomical information linked to voltage and activation data from local electrograms to help define regions of abnormal tissue, representing arrhythmic substrates which are amenable to ablation therapy. Unfortunately, the accuracy of these reconstructed images can be affected by intravascular volume changes, respiratory motion, patient movement, and electrical interference from surrounding equipment which can lead to inaccurate representation of the true cardiac anatomy and misguide adequate therapy. The use of linear image acquisition techniques such as computed tomography (CT), magnetic resonance imaging (MRI), and positron-emission tomography (PET) provides high-resolution cardiac image datasets which can be integrated with the 3D maps in a process called image integration or image fusion. Thus, the combination of pre-procedural linear imaging technology with intra-procedural imaging techniques such as 3D electroanatomical mapping and intracardiac ultrasound (ICE) allows real-time, accurate high-resolution anatomical reconstruction of cardiac structures.

This chapter describes the process of image integration between pre-procedural imaging incorporated into 3D maps and intracardiac ultrasound and its clinical applicability to a wide variety of atrial and ventricular arrhythmias to safely and effectively guide complex ablation procedures.

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Acknowledgments

The authors acknowledge the assistance of Angela Uribe (Biosense Webster, Latin America) and Thomas Severino (Biosense Webster, USA) with the preparation of some of the images presented in this chapter.

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Authors and Affiliations

  1. Cardiology Department, Wellington Regional Hospital, Wellington, New Zealand

    Alejandro Jimenez Restrepo MD

  2. International Arrhythmia Center, Fundacion Cardioinfantil, Bogota, Colombia

    Alejandro Jimenez Restrepo MD

  3. Division of Cardiology, University of Maryland Medical Center, Baltimore, MD, USA

    Timm M. Dickfeld MD, PhD

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  1. Alejandro Jimenez Restrepo MD
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  2. Timm M. Dickfeld MD, PhD
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Correspondence to Alejandro Jimenez Restrepo MD .

Editor information

Editors and Affiliations

  1. Department of Cardiology, Center Hospitalier Coutances, Coutances, France

    Ambrose S. Kibos

  2. Department of Internal Medicine Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA

    Bradley P. Knight

  3. Division of Cardiology, McGill University Health Center, Montreal, Québec, Canada

    Vidal Essebag

  4. Department of Cardiology, Miami Children's Hospital, Miami, Florida, USA

    Steven B. Fishberger

  5. School of Biology, Chemistry and Health, Manchester Metropolitan University, Manchester, United Kingdom

    Mark Slevin

  6. “Acad. Vasile Candea” Emergency Clinical Center for Cardiovascular Diseases, “Carol Davila” University of Medicine and Pharmacy, “Titu Maiorescu” University Faculty of Medicine,, Bucharest, Romania

    Ion C. Țintoiu

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© 2014 Springer-Verlag London

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Restrepo, A.J., Dickfeld, T.M. (2014). Cardiac Imaging to Assist Complex Ablation Procedures. In: Kibos, A., Knight, B., Essebag, V., Fishberger, S., Slevin, M., Țintoiu, I. (eds) Cardiac Arrhythmias. Springer, London. https://doi.org/10.1007/978-1-4471-5316-0_29

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  • DOI: https://doi.org/10.1007/978-1-4471-5316-0_29

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