Development of an electrophysiology (EP)-enabled intracardiac ultrasound catheter integrated with NavX 3-dimensional electrofield mapping for guiding cardiac EP interventions: Experimental studies

Kui Li Xiao, James Pemberton, Kai Thomenius, Aaron Dentinger, Robert I. Lowe, Muhammad Ashraf, K. Kirk Shung, Raymond Chia, Douglas N. Stephens, Matthew O'Donnell, Aman Mahajan, Seshadri Balaji, Kalyanam Shivkumar, David Sahn

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective. We have developed an integrated high-resolution intracardiac echocardiography (ICE) catheter for electrophysiology (EP) testing, which can be coregistered in 3-dimensional space with EP testing and ablation catheters using electrofield sensing. Methods. Twelve open-chest pigs (34-55 kg) and 3 closed-chest pigs were studied. After introduction from the jugular or femoral venous locations, the 9F side-looking, highly steerable (0°-180°), 64-element array catheters could be manipulated easily throughout the right side of the heart. Multisite cardiac pacing was performed for assessing left ventricular (LV) synchrony using tissue Doppler methods. Also, in the open-chest pigs, right atrial (RA) and right ventricular (RV) ablations were performed with a separate radio frequency catheter under fluoroscopic guidance and visualized with ICE to characterize the changes. In the 3 closed-chest pigs, electrofield NavX 3-dimensional coregistration (St Jude Medical Corp, Minneapolis, MN) allowed us to test whether this additional feature could shorten the time necessary to perform 4 targeted ablations in each animal while imaging the ablation catheter and the adjacent region by ICE. Results. Intracardiac anatomy, tricuspid, aortic, pulmonary, and mitral valve function, and pulmonary vein flow were all imaged reproducibly from scanning locations in the RA or RV in all animals, along with assessment of cardiac motion and the effects of multisite pacing. Three-dimensional electrofield displays detailed the spatial relationship between the ICE catheter and ablation catheters such that the time to visualize and ablate 4 sites in each of the 3 closed-chest animals was reduced. Conclusions. This new technology is a first step in the integration of ICE with EP procedures.

Original languageEnglish (US)
Pages (from-to)1565-1574
Number of pages10
JournalJournal of Ultrasound in Medicine
Volume26
Issue number11
StatePublished - Nov 2007

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electrophysiology
Cardiac Electrophysiology
Cardiac Catheters
echocardiography
Electrophysiology
chest
swine
ablation
Echocardiography
Thorax
Catheter Ablation
Swine
animals
Catheters
Pulmonary Valve
Tricuspid Valve
Pulmonary Veins
anatomy
Thigh
Radio

Keywords

  • Improved resolution
  • Integrated
  • Intracardiac imaging
  • Rhythm analysis
  • Steerability

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology
  • Acoustics and Ultrasonics

Cite this

Development of an electrophysiology (EP)-enabled intracardiac ultrasound catheter integrated with NavX 3-dimensional electrofield mapping for guiding cardiac EP interventions : Experimental studies. / Xiao, Kui Li; Pemberton, James; Thomenius, Kai; Dentinger, Aaron; Lowe, Robert I.; Ashraf, Muhammad; Shung, K. Kirk; Chia, Raymond; Stephens, Douglas N.; O'Donnell, Matthew; Mahajan, Aman; Balaji, Seshadri; Shivkumar, Kalyanam; Sahn, David.

In: Journal of Ultrasound in Medicine, Vol. 26, No. 11, 11.2007, p. 1565-1574.

Research output: Contribution to journalArticle

Xiao, KL, Pemberton, J, Thomenius, K, Dentinger, A, Lowe, RI, Ashraf, M, Shung, KK, Chia, R, Stephens, DN, O'Donnell, M, Mahajan, A, Balaji, S, Shivkumar, K & Sahn, D 2007, 'Development of an electrophysiology (EP)-enabled intracardiac ultrasound catheter integrated with NavX 3-dimensional electrofield mapping for guiding cardiac EP interventions: Experimental studies', Journal of Ultrasound in Medicine, vol. 26, no. 11, pp. 1565-1574.
Xiao, Kui Li ; Pemberton, James ; Thomenius, Kai ; Dentinger, Aaron ; Lowe, Robert I. ; Ashraf, Muhammad ; Shung, K. Kirk ; Chia, Raymond ; Stephens, Douglas N. ; O'Donnell, Matthew ; Mahajan, Aman ; Balaji, Seshadri ; Shivkumar, Kalyanam ; Sahn, David. / Development of an electrophysiology (EP)-enabled intracardiac ultrasound catheter integrated with NavX 3-dimensional electrofield mapping for guiding cardiac EP interventions : Experimental studies. In: Journal of Ultrasound in Medicine. 2007 ; Vol. 26, No. 11. pp. 1565-1574.
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abstract = "Objective. We have developed an integrated high-resolution intracardiac echocardiography (ICE) catheter for electrophysiology (EP) testing, which can be coregistered in 3-dimensional space with EP testing and ablation catheters using electrofield sensing. Methods. Twelve open-chest pigs (34-55 kg) and 3 closed-chest pigs were studied. After introduction from the jugular or femoral venous locations, the 9F side-looking, highly steerable (0°-180°), 64-element array catheters could be manipulated easily throughout the right side of the heart. Multisite cardiac pacing was performed for assessing left ventricular (LV) synchrony using tissue Doppler methods. Also, in the open-chest pigs, right atrial (RA) and right ventricular (RV) ablations were performed with a separate radio frequency catheter under fluoroscopic guidance and visualized with ICE to characterize the changes. In the 3 closed-chest pigs, electrofield NavX 3-dimensional coregistration (St Jude Medical Corp, Minneapolis, MN) allowed us to test whether this additional feature could shorten the time necessary to perform 4 targeted ablations in each animal while imaging the ablation catheter and the adjacent region by ICE. Results. Intracardiac anatomy, tricuspid, aortic, pulmonary, and mitral valve function, and pulmonary vein flow were all imaged reproducibly from scanning locations in the RA or RV in all animals, along with assessment of cardiac motion and the effects of multisite pacing. Three-dimensional electrofield displays detailed the spatial relationship between the ICE catheter and ablation catheters such that the time to visualize and ablate 4 sites in each of the 3 closed-chest animals was reduced. Conclusions. This new technology is a first step in the integration of ICE with EP procedures.",
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T1 - Development of an electrophysiology (EP)-enabled intracardiac ultrasound catheter integrated with NavX 3-dimensional electrofield mapping for guiding cardiac EP interventions

T2 - Experimental studies

AU - Xiao, Kui Li

AU - Pemberton, James

AU - Thomenius, Kai

AU - Dentinger, Aaron

AU - Lowe, Robert I.

AU - Ashraf, Muhammad

AU - Shung, K. Kirk

AU - Chia, Raymond

AU - Stephens, Douglas N.

AU - O'Donnell, Matthew

AU - Mahajan, Aman

AU - Balaji, Seshadri

AU - Shivkumar, Kalyanam

AU - Sahn, David

PY - 2007/11

Y1 - 2007/11

N2 - Objective. We have developed an integrated high-resolution intracardiac echocardiography (ICE) catheter for electrophysiology (EP) testing, which can be coregistered in 3-dimensional space with EP testing and ablation catheters using electrofield sensing. Methods. Twelve open-chest pigs (34-55 kg) and 3 closed-chest pigs were studied. After introduction from the jugular or femoral venous locations, the 9F side-looking, highly steerable (0°-180°), 64-element array catheters could be manipulated easily throughout the right side of the heart. Multisite cardiac pacing was performed for assessing left ventricular (LV) synchrony using tissue Doppler methods. Also, in the open-chest pigs, right atrial (RA) and right ventricular (RV) ablations were performed with a separate radio frequency catheter under fluoroscopic guidance and visualized with ICE to characterize the changes. In the 3 closed-chest pigs, electrofield NavX 3-dimensional coregistration (St Jude Medical Corp, Minneapolis, MN) allowed us to test whether this additional feature could shorten the time necessary to perform 4 targeted ablations in each animal while imaging the ablation catheter and the adjacent region by ICE. Results. Intracardiac anatomy, tricuspid, aortic, pulmonary, and mitral valve function, and pulmonary vein flow were all imaged reproducibly from scanning locations in the RA or RV in all animals, along with assessment of cardiac motion and the effects of multisite pacing. Three-dimensional electrofield displays detailed the spatial relationship between the ICE catheter and ablation catheters such that the time to visualize and ablate 4 sites in each of the 3 closed-chest animals was reduced. Conclusions. This new technology is a first step in the integration of ICE with EP procedures.

AB - Objective. We have developed an integrated high-resolution intracardiac echocardiography (ICE) catheter for electrophysiology (EP) testing, which can be coregistered in 3-dimensional space with EP testing and ablation catheters using electrofield sensing. Methods. Twelve open-chest pigs (34-55 kg) and 3 closed-chest pigs were studied. After introduction from the jugular or femoral venous locations, the 9F side-looking, highly steerable (0°-180°), 64-element array catheters could be manipulated easily throughout the right side of the heart. Multisite cardiac pacing was performed for assessing left ventricular (LV) synchrony using tissue Doppler methods. Also, in the open-chest pigs, right atrial (RA) and right ventricular (RV) ablations were performed with a separate radio frequency catheter under fluoroscopic guidance and visualized with ICE to characterize the changes. In the 3 closed-chest pigs, electrofield NavX 3-dimensional coregistration (St Jude Medical Corp, Minneapolis, MN) allowed us to test whether this additional feature could shorten the time necessary to perform 4 targeted ablations in each animal while imaging the ablation catheter and the adjacent region by ICE. Results. Intracardiac anatomy, tricuspid, aortic, pulmonary, and mitral valve function, and pulmonary vein flow were all imaged reproducibly from scanning locations in the RA or RV in all animals, along with assessment of cardiac motion and the effects of multisite pacing. Three-dimensional electrofield displays detailed the spatial relationship between the ICE catheter and ablation catheters such that the time to visualize and ablate 4 sites in each of the 3 closed-chest animals was reduced. Conclusions. This new technology is a first step in the integration of ICE with EP procedures.

KW - Improved resolution

KW - Integrated

KW - Intracardiac imaging

KW - Rhythm analysis

KW - Steerability

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