Probabilistic guidance for catheter tip motion in cardiac ablation procedures

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Title: Probabilistic guidance for catheter tip motion in cardiac ablation procedures
Authors: Constantinescu, MA
Lee, S-L
Ernst, S
Hemakom, A
Mandic, D
Yang, G-Z
Item Type: Journal Article
Abstract: Radiofrequency catheter ablation is one of the commonly available therapeutic methods for patients suffering from cardiac arrhythmias. The prerequisite of successful ablation is sufficient energy delivery at the target site. However, cardiac and respiratory motion, coupled with endocardial irregularities, can cause catheter drift and dispersion of the radiofrequency energy, thus prolonging procedure time, damaging adjacent tissue, and leading to electrical reconnection of temporarily ablated regions. Therefore, positional accuracy and stability of the catheter tip during energy delivery is of great importance for the outcome of the procedure. This paper presents an analytical scheme for assessing catheter tip stability, whereby a sequence of catheter tip motion recorded at sparse locations on the endocardium is decomposed. The spatial sliding component along the endocardial wall is extracted from the recording and maximal slippage and its associated probability are computed at each mapping point. Finally, a global map is generated, allowing the assessment of potential areas that are compromised by tip slippage. The proposed framework was applied to 40 retrospective studies of congenital heart disease patients and further validated on phantom data and simulations. The results show a good correlation with other intraoperative factors, such as catheter tip contact force amplitude and orientation, and with clinically documented anatomical areas of high catheter tip instability.
Issue Date: 1-Jul-2018
Date of Acceptance: 20-Mar-2018
ISSN: 1361-8415
Publisher: Elsevier
Start Page: 1
End Page: 14
Journal / Book Title: Medical Image Analysis
Volume: 47
Copyright Statement: Crown Copyright © 2018 Published by Elsevier B.V. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
Keywords: Cardiac ablation
Catheter motion
Intraoperative guidance
Multivariate empirical mode decomposition (MEMD)
Probabilistic map
09 Engineering
11 Medical And Health Sciences
Nuclear Medicine & Medical Imaging
Publication Status: Published
Conference Place: Netherlands
Online Publication Date: 2018-03-23
Appears in Collections:Faculty of Engineering
Electrical and Electronic Engineering
Faculty of Medicine

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