Cited 37 times since 2000 (1.6 per year) source: EuropePMC Journal of cardiovascular electrophysiology, Volume 11, Issue 11, 1 1 2000, Pages 1183-1192 Three-dimensional catheter positioning during radiofrequency ablation in patients: first application of a real-time position management system. de Groot NM, Bootsma M, van der Velde ET, Schalij MJ
Introduction
Precise localization of target sites for radiofrequency catheter ablation (RFCA) of arrhythmias is hampered by the relative inaccuracy of X-ray localization procedures. This study evaluated the efficacy of a three-dimensional (3D) real-time position management system in guiding RFCA procedures in patients.
Methods and results
Patients (n = 30, age 59+/-20 years) referred for ablation of either atrial flutter (n = 10), ventricular tachycardia (n = 15), or accessory pathways (n = 5) were studied. The real-time position management system uses ultrasound ranging techniques to track the position of an ablation catheter relative to two multitransducer reference catheters, positioned in the right atrium or coronary sinus and the right ventricle. Each catheter contains three or four ultrasound transducers. The distance between the transducer(s) is determined by calculating the time necessary for an ultrasound pulse to reach other transducers, assuming the speed of sound in blood is 1,550 m/sec. The proximal His bundle was marked at the beginning and the end of the procedure as an electrical landmark to verify reproducibility. After identification of target sites, the position of each lesion created with the ablation catheter was marked. Successful ablation was achieved in 94% of the patients. The distance between the location of the proximal His bundle as marked at the beginning and at the end of the procedure was 2.0+/-1.2 mm (range 1.5 to 3.5).
Conclusion
The new 3D real-time position management system facilitated RFCA procedures as it allowed accurate and reproducible 3D tracking of the mapping and ablation catheter.
