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Proceedings Paper

XMR guided cardiac electrophysiology study and radio frequency ablation
Author(s): Kawal S. Rhode; Maxime Sermesant; Sanjeet Hegde; Gerardo I. Sanchez-Ortiz; Daniel Rueckert; Reza Razavi; Derek L. G. Hill
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Paper Abstract

XMR systems are a new type of interventional facility in which patients can be rapidly transferred between x-ray and MR systems on a floating table. We have previously developed a technique to register MR and x-ray images obtained from such systems. We are carrying out a program of XMR guided cardiac electrophysiology study (EPS) and radio frequency ablation (RFA). The aim of our work was to apply our registration technology to XMR guided EPS/RFA in order to integrate anatomical, electrophysiological and motion information. This would assist in guidance and allow us to validate and refine electromechanical models. Registration of the imaging modalities was achieved by a combination of system calibration and real-time optical tracking. Patients were initially imaged using MR imaging. An SSFP volume scan of the heart was acquired for anatomical information, followed by tagged scans for motion information. The patients were then transferred to the x-ray system. Tracked biplane x-ray images were acquired while electrical measurements were made from catheters placed in the heart. The relationship between the MR and x-ray images was determined. The MR volume scan of the heart was segmented and the tagged scans were analysed using a non-rigid registration algorithm to compute motion. The position of catheters was reconstructed within the MR cardiac anatomy. The anatomical, electrophysiological, and motion information were displayed in the same coordinate system. Simulations of electrical depolarisation and contraction were performed using electromechanical models of the myocardium. We present results for 2 initial cases. For patient 1, a contact mapping system was used for the EPS and for patient 2, a non-contact mapping system was used. Our XMR registration technique allows the integration of anatomical, electrophysiological, and motion information for patients undergoing EPS/RFA. This integrated approach has assisted in interventional guidance and has been used to validate electromechanical models of the myocardium.

Paper Details

Date Published: 30 April 2004
PDF: 12 pages
Proc. SPIE 5369, Medical Imaging 2004: Physiology, Function, and Structure from Medical Images, (30 April 2004); doi: 10.1117/12.535103
Show Author Affiliations
Kawal S. Rhode, King’s College London (United Kingdom)
Maxime Sermesant, King’s College London (United Kingdom)
Sanjeet Hegde, King’s College London (United Kingdom)
Gerardo I. Sanchez-Ortiz, Imperial College London (United Kingdom)
Daniel Rueckert, Imperial College London (United Kingdom)
Reza Razavi, King’s College London (United Kingdom)
Derek L. G. Hill, King’s College London (United Kingdom)


Published in SPIE Proceedings Vol. 5369:
Medical Imaging 2004: Physiology, Function, and Structure from Medical Images
Amir A. Amini; Armando Manduca, Editor(s)

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