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Time-resolved three-dimensional imaging of the left atrium and pulmonary veins in the interventional suite-A comparison between multisweep gated rotational three-dimensional reconstructed fluoroscopy and multislice computed tomography
Cardiac Arrhythmia Service, Stanford University Medical School, Stanford, CA, United States.
Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
Siemens AG, Medical Solutions, Forchheim, Germany.
Cardiac Arrhythmia Service, Stanford University Medical School, Stanford, CA, United States.
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2008 (English)In: Heart Rhythm, ISSN 1547-5271, Vol. 5, no 4, 513-519 p.Article in journal (Refereed) Published
Abstract [en]

Background: Cardiac computed tomography (CT) is commonly used to visualize left atrial (LA) anatomy for ablation of atrial fibrillation. We have developed a new imaging technique that allows acquisition and visualization of three-dimensional (3D) cardiac images in the catheter lab. Objective: We sought to compare LA and pulmonary vein (PV) dimensions acquired using gated multisweep rotational fluoroscopy (C-arm CT) system and multislice computed tomography (MSCT) in an in vivo porcine model. Methods: A Siemens AXIOM Artis dTA C-arm system (Siemens AG, Medical Solutions) was modified to allow acquisition of four bidirectional sweeps during synchronized acquisition of the electrocardiogram signal to allow retrospective gating. C-arm CT image volumes were then reconstructed. Gated MSCT (SOMATOM Sensation 16 and 64, Siemens AG, Medical Solutions) and C-arm CT images were acquired in six animals. The two main PV diameters were measured in orthogonal axes. LA volumes were calculated. C-arm CT measurements were compared with the MSCT measurements. Results: The average PV diameters using the C-arm CT were 2.24 × 1.35 cm, versus 2.27 × 1.38 cm for CT. The average difference was 0.034 cm (1.9%) between the C-arm CT and standard CT. The average LA volume using MSCT was 49.1 ± 12.7 cm3, as compared with 51.0 ± 8.7 cm3 obtained by the C-arm CT. The average difference between the C-arm CT and the MSCT was 1.9 cm3 (3.7%). There were no significant differences in either the PV or LA measurements. Conclusions: Visualization of 3D cardiac anatomy during ablation procedures is possible and highly accurate. The 3D cardiac reconstructions acquired during ablation procedures will be valuable for procedural planning and guidance. © 2008 Heart Rhythm Society.

Place, publisher, year, edition, pages
2008. Vol. 5, no 4, 513-519 p.
Keyword [en]
3D imaging, C-arm CT, Computed tomography, Multisegment reconstruction, Pulmonary veins, Retrospective cardiac gating
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-46477DOI: 10.1016/j.hrthm.2007.12.027OAI: diva2:267373
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2011-01-10

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Wigström, Lars
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