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Magnetically guided left ventricular lead implantation based on a virtual three-dimensional reconstructed image of the coronary sinus

Maximo Rivero-Ayerza, Emil Jessurun, Steve Ramcharitar, Yves van Belle, Patrick W Serruys and Luc Jordaens UGent (2008) EUROPACE. 10(9). p.1042-1047
abstract
Aims: Left ventricular (W) lead implantation is feasible using remote magnetic navigation of a guidewire (Stereotaxis, St Louis, MO, USA). A novel software that performs a three-dimensional (3D) reconstruction of vessels based on two or more angiographic views has been developed recently (CardiOp-B system (TM), Paeion Inc., Haifa, Israel). The objective of this paper is to evaluate: (i) the performance of the 3D reconstruction software which reproduce the anatomy of the coronary sinus (CS) and (ii) the efficacy of remotely navigating a magnetic guidewire within the CS based on this reconstruction. Methods and results: In patients undergoing cardiac resynchronization therapy implantation, a 3D reconstruction of the CS was performed using the CardiOp-B (TM) system. Accuracy of the reconstruction was evaluated by comparing with the CS angiogram. This reconstruction was imported into the Stereotaxis system. On the basis of the reconstruction, magnetic vectors were automatically selected to navigate within the CS and manually adjusted if required. Feasibility of deploying the guidewire and LV lead into the selected side branch (SB), fluoroscopy time (FT) required for cannulation of the target SB, and total FT were also evaluated. Sixteen patients were included. In one case, the software could not reconstruct the CS. The quality of the reconstruction was graded as good in 13 and poor in 2. In 10 cases, manual adjustments to the traced edges of the CS were required to perform the 3D reconstruction, and in 5, no adjustments were required. In 13 patients, the target SB was engaged on the basis of the automatically selected vectors. In two cases, manual modification of the vector was required. Mean total FT was 23 +/- 14 min and the FT required to cannulate the target SB was 1.7 +/- 1.3 min. Conclusion: A 3D reconstruction of the CS can be accurately performed using two angiographic views. This reconstruction allows precise magnetic navigation of a guidewire within the CS.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
three-dimensional reconstruction, left ventricular lead, cardiac resynchronization therapy, magnetic navigation, implantation, NAVIGATION SYSTEM, ANGIOGRAPHY, EXPERIENCE, ABLATION
journal title
EUROPACE
Europace
volume
10
issue
9
pages
1042 - 1047
Web of Science type
Article
Web of Science id
000259541400003
JCR category
CARDIAC & CARDIOVASCULAR SYSTEMS
JCR impact factor
1.706 (2008)
JCR rank
49/78 (2008)
JCR quartile
3 (2008)
ISSN
1099-5129
DOI
10.1093/europace/eun173
language
English
UGent publication?
no
classification
A1
id
8151498
handle
http://hdl.handle.net/1854/LU-8151498
date created
2016-11-15 13:46:01
date last changed
2016-12-19 15:41:39
@article{8151498,
  abstract     = {Aims: Left ventricular (W) lead implantation is feasible using remote magnetic navigation of a guidewire (Stereotaxis, St Louis, MO, USA). A novel software that performs a three-dimensional (3D) reconstruction of vessels based on two or more angiographic views has been developed recently (CardiOp-B system (TM), Paeion Inc., Haifa, Israel). The objective of this paper is to evaluate: (i) the performance of the 3D reconstruction software which reproduce the anatomy of the coronary sinus (CS) and (ii) the efficacy of remotely navigating a magnetic guidewire within the CS based on this reconstruction.
Methods and results: In patients undergoing cardiac resynchronization therapy implantation, a 3D reconstruction of the CS was performed using the CardiOp-B (TM) system. Accuracy of the reconstruction was evaluated by comparing with the CS angiogram. This reconstruction was imported into the Stereotaxis system. On the basis of the reconstruction, magnetic vectors were automatically selected to navigate within the CS and manually adjusted if required. Feasibility of deploying the guidewire and LV lead into the selected side branch (SB), fluoroscopy time (FT) required for cannulation of the target SB, and total FT were also evaluated. Sixteen patients were included. In one case, the software could not reconstruct the CS. The quality of the reconstruction was graded as good in 13 and poor in 2. In 10 cases, manual adjustments to the traced edges of the CS were required to perform the 3D reconstruction, and in 5, no adjustments were required. In 13 patients, the target SB was engaged on the basis of the automatically selected vectors. In two cases, manual modification of the vector was required. Mean total FT was 23 +/- 14 min and the FT required to cannulate the target SB was 1.7 +/- 1.3 min.
Conclusion: A 3D reconstruction of the CS can be accurately performed using two angiographic views. This reconstruction allows precise magnetic navigation of a guidewire within the CS.},
  author       = {Rivero-Ayerza, Maximo and Jessurun, Emil and Ramcharitar, Steve and van Belle, Yves and Serruys, Patrick W and Jordaens, Luc},
  issn         = {1099-5129},
  journal      = {EUROPACE},
  keyword      = {three-dimensional reconstruction,left ventricular lead,cardiac resynchronization therapy,magnetic navigation,implantation,NAVIGATION SYSTEM,ANGIOGRAPHY,EXPERIENCE,ABLATION},
  language     = {eng},
  number       = {9},
  pages        = {1042--1047},
  title        = {Magnetically guided left ventricular lead implantation based on a virtual three-dimensional reconstructed image of the coronary sinus},
  url          = {http://dx.doi.org/10.1093/europace/eun173},
  volume       = {10},
  year         = {2008},
}

Chicago
Rivero-Ayerza, Maximo, Emil Jessurun, Steve Ramcharitar, Yves van Belle, Patrick W Serruys, and Luc Jordaens. 2008. “Magnetically Guided Left Ventricular Lead Implantation Based on a Virtual Three-dimensional Reconstructed Image of the Coronary Sinus.” Europace 10 (9): 1042–1047.
APA
Rivero-Ayerza, Maximo, Jessurun, E., Ramcharitar, S., van Belle, Y., Serruys, P. W., & Jordaens, L. (2008). Magnetically guided left ventricular lead implantation based on a virtual three-dimensional reconstructed image of the coronary sinus. EUROPACE, 10(9), 1042–1047.
Vancouver
1.
Rivero-Ayerza M, Jessurun E, Ramcharitar S, van Belle Y, Serruys PW, Jordaens L. Magnetically guided left ventricular lead implantation based on a virtual three-dimensional reconstructed image of the coronary sinus. EUROPACE. 2008;10(9):1042–7.
MLA
Rivero-Ayerza, Maximo, Emil Jessurun, Steve Ramcharitar, et al. “Magnetically Guided Left Ventricular Lead Implantation Based on a Virtual Three-dimensional Reconstructed Image of the Coronary Sinus.” EUROPACE 10.9 (2008): 1042–1047. Print.