Analysis of left atrial respiratory and cardiac motion for cardiac ablation therapy

M. E. Rettmann; D. R. Holmes III; S. B. Johnson; H. I. Lehmann; R. A. Robb; D. L. Packer

doi:10.1117/12.2081209

18 March 2015 Analysis of left atrial respiratory and cardiac motion for cardiac ablation therapy

M. E. Rettmann, D. R. Holmes III, S. B. Johnson, H. I. Lehmann, R. A. Robb, D. L. Packer

Proceedings Volume 9415, Medical Imaging 2015: Image-Guided Procedures, Robotic Interventions, and Modeling; 94152L (2015) https://doi.org/10.1117/12.2081209
Event: SPIE Medical Imaging, 2015, Orlando, Florida, United States

Abstract

Cardiac ablation therapy is often guided by models built from preoperative computed tomography (CT) or magnetic resonance imaging (MRI) scans. One of the challenges in guiding a procedure from a preoperative model is properly synching the preoperative models with cardiac and respiratory motion through computational motion models. In this paper, we describe a methodology for evaluating cardiac and respiratory motion in the left atrium and pulmonary veins of a beating canine heart. Cardiac catheters were used to place metal clips within and near the pulmonary veins and left atrial appendage under fluoroscopic and ultrasound guidance and a contrast-enhanced, 64-slice multidetector CT scan was collected with the clips in place. Each clip was segmented from the CT scan at each of the five phases of the cardiac cycle at both end-inspiration and end-expiration. The centroid of each segmented clip was computed and used to evaluate both cardiac and respiratory motion of the left atrium. A total of three canine studies were completed, with 4 clips analyzed in the first study, 5 clips in the second study, and 2 clips in the third study. Mean respiratory displacement was 0.2±1.8 mm in the medial/lateral direction, 4.7±4.4 mm in the anterior/posterior direction (moving anterior on inspiration), and 9.0±5.0 mm superior/inferior (moving inferior with inspiration). At end inspiration, the mean left atrial cardiac motion at the clip locations was 1.5±1.3 mm in the medial/lateral direction, and 2.1±2.0 mm in the anterior/posterior and 1.3±1.2 mm superior/inferior directions. At end expiration, the mean left atrial cardiac motion at the clip locations was 2.0±1.5mm in the medial/lateral direction, 3.0±1.8mm in the anterior/posterior direction, and 1.5±1.5 mm in the superior/inferior directions.

Citation Download Citation

M. E. Rettmann, D. R. Holmes III, S. B. Johnson, H. I. Lehmann, R. A. Robb, and D. L. Packer "Analysis of left atrial respiratory and cardiac motion for cardiac ablation therapy", Proc. SPIE 9415, Medical Imaging 2015: Image-Guided Procedures, Robotic Interventions, and Modeling, 94152L (18 March 2015); https://doi.org/10.1117/12.2081209

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