In the Hollywood Private Hospital in Perth, Australia, the department of cardiology is using magnetic resonance image (MRI) overlay to help the electrophysiologist to understand the anatomy and plan the right ablation strategy for pulmonary vein isolations. The 3D image is superimposed onto the live fluoroscopy, improving the guidance of the catheter during ablation therapy in electrophysiology (EP) lab.
Lower dose exposure and reduced prep time
Using this technology, major aspects of anatomy such as the intervenous ridges, venous caliber, early branching, accessory veins, roof ouches, and appendage position can be appreciated. According to Rukshen Weerasooriya, MD, Department of Cardiology, Hollywood Private Hospital, the MRI overlay has the advantage of lower exposure to ionizing radiation. The fluoro overlay involves a surface model generated using syngo® InSpace EP and syngo iPilot. The magnetic resonance images were obtained using a Siemens MAGNETOM®1.5T Avanto scanner. Prior to the ablation procedure, a low dose 5-second 3D rotational fluoroscopic imaging without contrast agent is performed.
As this can be performed with the clinical staff out of the room, the technique poses a marked dose reduction to the operator. While cases are performed with similar fluoro time, radiation dose to the patient and procedure time, the preparation time has been reduced. “The ability to leave tags at abalation sites gives us confidence. The clear demonstration of anatomical variants of the pulmonary veins is really important as there is no such thing as normal left atrial anatomy – variation is the norm,” explains Weerasooriya.
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