- Poster presentation
- Open Access
Feasibility of real time integration of high-resolution scar images with invasive electrograms in electro-anatomical mapping system in patients undergoing ventricular tachycardia ablation
© Roujol et al; licensee BioMed Central Ltd. 2013
- Published: 30 January 2013
- Ventricular Tachycardia
- Late Gadolinium Enhancement
- Late Gadolinium Enhancement Image
- Epicardial Surface
- Ventricular Tachycardia Ablation
Ventricular tachycardia (VT) ablation is generally guided by invasive mapping of the left ventricle (LV) using electro-anatomical voltage mapping (EAM) to identify the VT substrate . Late gadolinium enhancement (LGE) MRI allows excellent visualization of the scar. Heterogeneous area in LGE images has been shown to correlate with the VT substrate in animal models of VT. Retrospective studies in patients have also correlated the LGE signal enhancement to low voltage in EAM maps. However, current clinical EAM platform such as the Carto3 (Biosense Webster) does not allow integration of LGE images for facilitating the VT ablation. In this study, we described a workflow to integrate scar geometry extracted from high-resolution 3D LGE images with EAM.
Using the proposed methodology, a VTK file representing the average transmural intensity of LGE was successfully generated (Figure 1). The LGE data processing was performed in ~20min (manual contour delineation ~20min and all remaining steps ~10s). The resulting VTK file was imported into the Carto3 system before ablation and successfully merged with EAM (Figure 1).
Real time integration of scar from high-resolution 3D LGE into the Carto3 system is now feasible which allows visualization of LGE scar, EAM voltage map and catheter location in real-time. Further clinical validation is needed to investigate the potential benefit of real time LGE integration for VT ablation guidance.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.