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在二维荧光透视检查中识别第三维度以创建三维心脏图谱。

Identifying the third dimension in 2D fluoroscopy to create 3D cardiac maps.

作者信息

Sra Jasbir, Krum David, Choudhuri Indrajit, Belanger Barry, Palma Mark, Brodnick Donald, Rowe Daniel B

机构信息

Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke's Medical Centers.

APN Health, LLC, Milwaukee, Wisconsin, USA.

出版信息

JCI Insight. 2016 Dec 22;1(21):e90453. doi: 10.1172/jci.insight.90453.

Abstract

Three-dimensional cardiac mapping is important for optimal visualization of the heart during cardiac ablation for the treatment of certain arrhythmias. However, many hospitals and clinics worldwide cannot afford the high cost of the current mapping systems. We set out to determine if, using predefined algorithms, comparable 3D cardiac maps could be created by a new device that relies on data generated from single-plane fluoroscopy and patient recording and monitoring systems, without the need for costly equipment, infrastructure changes, or specialized catheters. The study included phantom and animal experiments to compare the prototype test device, Navik 3D, with the existing CARTO 3 System. The primary endpoint directly compared: (a) the 3D distance between the Navik 3D-simulated ablation location and the back-projected ground truth location of the pacing and mapping catheter electrode, and (b) the same distance for CARTO. The study's primary objective was considered met if the 95% confidence lower limit was greater than 0.75% for the Navik 3D-CARTO difference between the 2 distances, or less than or equal to 2 mm. Study results showed that the Navik 3D performance was equivalent to the CARTO system, and that accurate 3D cardiac maps can be created using data from equipment that already exists in all electrophysiology labs.

摘要

三维心脏标测对于在治疗某些心律失常的心脏消融过程中实现心脏的最佳可视化非常重要。然而,全球许多医院和诊所负担不起当前标测系统的高昂成本。我们着手确定,使用预定义算法,一种依赖于单平面荧光透视以及患者记录和监测系统生成的数据的新设备,能否在无需昂贵设备、基础设施改造或专用导管的情况下创建可比的三维心脏图谱。该研究包括体模和动物实验,以将原型测试设备Navik 3D与现有的CARTO 3系统进行比较。主要终点直接比较:(a) Navik 3D模拟消融位置与起搏和标测导管电极的反向投影真实位置之间的三维距离,以及(b) CARTO的相同距离。如果两个距离之间的Navik 3D - CARTO差异的95%置信下限大于0.75%,或小于或等于2毫米,则认为该研究的主要目标达成。研究结果表明,Navik 3D的性能与CARTO系统相当,并且可以使用所有电生理实验室中已有的设备数据创建准确的三维心脏图谱。

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2012 HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design: a report of the Heart Rhythm Society (HRS) Task Force on Catheter and Surgical Ablation of Atrial Fibrillation. Developed in partnership with the European Heart Rhythm Association (EHRA), a registered branch of the European Society of Cardiology (ESC) and the European Cardiac Arrhythmia Society (ECAS); and in collaboration with the American College of Cardiology (ACC), American Heart Association (AHA), the Asia Pacific Heart Rhythm Society (APHRS), and the Society of Thoracic Surgeons (STS). Endorsed by the governing bodies of the American College of Cardiology Foundation, the American Heart Association, the European Cardiac Arrhythmia Society, the European Heart Rhythm Association, the Society of Thoracic Surgeons, the Asia Pacific Heart Rhythm Society, and the Heart Rhythm Society.2012年心房颤动导管消融与外科消融专家共识声明:患者选择、手术技术、患者管理与随访、定义、终点及研究试验设计的建议:心律学会(HRS)心房颤动导管消融与外科消融特别工作组报告。与欧洲心脏病学会(ESC)注册分支欧洲心律协会(EHRA)及欧洲心脏心律失常学会(ECAS)合作制定;并与美国心脏病学会(ACC)、美国心脏协会(AHA)、亚太心律学会(APHRS)和胸外科医师学会(STS)协作。得到美国心脏病学会基金会、美国心脏协会、欧洲心脏心律失常学会、欧洲心律协会、胸外科医师学会、亚太心律学会和心律学会管理机构的认可。
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Mapping techniques for atrial fibrillation ablation.心房颤动消融的标测技术
Curr Probl Cardiol. 2007 Dec;32(12):669-767. doi: 10.1016/j.cpcardiol.2007.09.002.
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Radiation exposure during catheter ablation of atrial fibrillation.心房颤动导管消融术中的辐射暴露
Circulation. 2004 Nov 9;110(19):3003-10. doi: 10.1161/01.CIR.0000146952.49223.11. Epub 2004 Oct 25.

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