Intracardiac Surgical Planning
Fig 1: Catheter Ablation in the Left Atrium. An Anterior-Posterior (above, left) view of the left atrium and an endoscopic view (above, right) of the ostia of the pulmonary views on the right side of left atrium. The green icon represents the real-time location of the catheter tip within the heart. The red points represent radio-frequency (RF) ablations which have been "mapped-down" to the surface of the patient-specific CT model after registering electroanatomical mapping data to the imaging data.

Introduction

Cardiac arrhythmias are the leading cause of morbitity and mortality in the United States. Minimally-invasive catheter-based therapy is a preferred method for treating these arrhythmias. Using an electroanatomical (EA) mapping system, it is possible to construct three-dimensional maps of ventricular and atrial chambers within the heart. These 3D constructs are then used to guide catheter ablation. However, these EA mapping procedures result in relatively sparse 3D cardiac maps, and a significant amount of time and skill are required to generate these maps. Pre-operative MR and CT imaging could greatly facilitate electrophysiology procedures by providing patient-specific anatomical and physiological information about normal and scarred myocardial tissue. We have developed a framework to register pre-operative imaging data to intra-operative electroanatomical mapping data.


Publications and Presentations
  • V. Reddy, Z. Malchano, P. Neuzil, R. Cury, G. Holmvang, J. Weichet, E. Schmidt, J. Ruskin. "Integration of Cardiac CT/MR Imaging with 3-Dimensional Electroanatomical Mapping to Guide Catheter Manipulation in the Left Atrium: Implications for Catheter Ablation of Atrial Fibrillation." Circulation 2004 (in review).

  • V. Reddy, Z. Malchano, G. Holmvang, E. Schmidt, A. d'Avila, C. Houghtaling, R. Chan, J. Ruskin. "Integration of Cardiac MR Imaging with 3-Dimensional Electroanatomical Mapping to Guide Left Ventricular Catheter Manipulation: Feasibility in a Porcine Model of Healed Myocardial Infarction" J ACC 2004 (accepted).

  • Z. Malchano, R. Chan, G. Holmvang, E. Schmidt, A. d'Avila, T. Brady, J. Ruskin, V. Reddy. "Registration Strategies for Alignment of Cardiac MRI Data with 3D Electrophysiological Maps". Proceedings of International Society for Magnetic Resonance in Medicine Eleventh Scientific Meeting and Exhibition (ISMRM 2003), July 10-16, 2003 Toronto, Ontario, Canada.

    • Researchers

    Zach Malchano (zjm@csail.mit.edu)
    Vivek Reddy, M.D. (vreddy@partners.org)
    Ray Chan, Ph.D. (rchan@mit.edu)
    William Wells, Ph.D. (sw@ai.mit.edu)

    Last modified: Thu Jul 30 04:18:39 Eastern Standard Time 2004