Fusion of multislice computed tomography imaging with three-dimensional electroanatomic mapping to guide radiofrequency catheter ablation procedures

BACKGROUND The outcome of catheter ablation procedures of cardiac arrhythmias depends on the ability to evaluate the underlying mechanism and to depict target sites for ablation. Fusion of different imaging modalities within one system may improve electroanatomic modeling and facilitate ablation procedures. OBJECTIVES The purpose of this study was to study the feasibility of fusion of multislice computed tomography (MSCT) with electroanatomic mapping to guide radiofrequency catheter ablation of atrial arrhythmias. METHODS Sixteen patients (15 men, age 54 +/- 7 years) with drug-refractory atrial fibrillation (AF) underwent 64-slice MSCT within 2 days before radiofrequency catheter ablation. MSCT data were imported to the Carto (TM) electroanatomic mapping system. Using the new CartoMerge (TM) Image Integration Module, the MSCT images and the electroanatomic map were aligned. A statistical algorithm provided information about the accuracy of the fusion process. RESULTS In all patients, MSCT images could be fused with the electroanatomic map. Mean distance between the mapping points and the MSCT surface ranged from 1.7 +/- 1.2 mm to 2.8 +/- 1.8 mm. This resulted in an average of 2.1 +/- 0.2 mm for the patient group as a whole. CONCLUSION MSCT images can be fused with the three-dimensional electroanatomic mapping system in an accurate manner. Anatomy-based catheter ablation procedures for atrial arrhythmias may be facilitated by integration of different imaging modalities.