Impact of catheter tip-tissue contact on three-dimensional left atrial geometries Relationship between the external structures and anatomic distortion of 3D fast anatomical mapping and high contact fo.pdfVIP

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Impact of catheter tip-tissue contact on three-dimensional left atrial geometries Relationship between the external structures and anatomic distortion of 3D fast anatomical mapping and high contact fo.pdf

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Impact of catheter tip-tissue contact on three-dimensional left atrial geometries Relationship between the external structures and anatomic distortion of 3D fast anatomical mapping and high contact fo.pdf

International Journal of Cardiology 222 (2016) 202–208 Contents lists available at ScienceDirect International Journal of Cardiology journal homepage: /locate/ijcard Impact of catheter tip-tissue contact on three-dimensional left atrial geometries: Relationship between the external structures and anatomic distortion of 3D fast anatomical mapping and high contact force guided images Naofumi Anjo MD a, Shiro Nakahara MD a,?, Yasuo Okumura MD b, Yuichi Hori MD a, Koichi Nagashima MD b, Takaaki Komatsu MD a, Akiko Hayashi MD a, Sayuki Kobayashi MD a, Yoshihiko Sakai MD a, Isao Taguchi MD a a Department of Cardiology, Dokkyo Medical University Koshigaya Hospital, Saitama, Japan b Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan article info Article history: Received 13 June 2016 Accepted 27 July 2016 Available online 28 July 2016 Keywords: Catheter ablation Atrial ?brillation Contact force abstract Background: A high catheter tip-tissue contact force (CF) with the myocardium may cause 3-dimensional (3D) map distortion, however, the in?uence of external structures surrounding the left atrium (LA) on that distortion remains unknown. This study characterized the impact of high CF mapping on the local LA geometry distortion. Methods: Thirty AF patients underwent 3D-ultrasound merged with CT images (3D-Merge-CT). The LA area in contact with external structures was identi?ed by enhanced CT. Fast-electroanatomical-mapping (FAM) geometries were created by two methods, point-by-point mapping with high (N10 g) CFs (high-CF guided-FAM), followed by that with multielectrode-mapping catheters (conventional-FAM). The resulting geometries were compared with the 3D-Merge-CT images. Results: Three representative anatomical contact areas (ascending aorta-vs.-anterior wall, descending aorta-vs.-left pulmonary vein [PV], and vertebrae-vs.-posterior wall) were identi?ed. The PV antrum distorted distance on the 3D-Merge-CT was signi?cantly long