Three-dimensional ultrasound for image-guided mapping and intervention: methods, quantitative validation, and clinical feasibility of a novel multimodality image mapping system.

摘要: Background— Multiple factors create discrepancies between electroanatomic maps and merged, preacquired computed tomographic images used in guiding atrial fibrillation ablation. Therefore, a Carto-based 3D ultrasound image system (Biosense Webster Inc) was validated an animal model tested 15 patients. Methods Results— Twelve dogs underwent evaluation using newly developed system. After fiducial clip markers were percutaneously implanted at critical locations each cardiac chamber, geometries, derived from family of 2D intracardiac echocardiographic images, constructed. Point-source error ultrasound-derived assessed by actual real-time sites, 2.1±1.1 mm for 2.4±1.2 ventricular sites. These errors significantly less than the variance on CartoMerge (atria: 3.3±1.6 mm; ventricles: 4.8±2.0 P< 0.001 both). Target ablation clip, guided only geometry, resulted lesions within 1.1±1.1 clips. Pulmonary vein geometry circumferential ablative lesions. Mapping patients produced modestly smaller versus map left volumes (98±24 cm3 109±25 cm3, 0.05). Three-dimensional ultrasound-guided pulmonary isolation linear these successfully performed with confirmation entrance/exit block. Conclusions— data demonstrate that seamlessly yield anatomically accurate chamber geometries. Image are more possible imaging. This clinical study also demonstrates initial feasibility this guidance fibrillation. Received September 18, 2007; accepted April 7, 2008. # CLINICAL PERSPECTIVE {#article-title-2}