First report of image integration of cine-angiography with 3D electro-anatomical mapping of the right ventricle in postoperative Tetralogy of Fallot

Mario Salvatore Russo, Daniela Righi, Corrado Di Mambro, Valentina Ruoppolo, Massimo Stefano Silvetti, Fabrizio Drago

Research output: Contribution to journalArticle

Abstract

Ventricular tachycardia and, more rarely, sudden cardiac death are potential complications affecting the long-term outcome after Tetralogy of Fallot (ToF) repair. Intraventricular septal scar, fibro-fatty substitution around infundibular resection and patchy myocardial fibrosis may provide anatomical substrates of abnormal depolarization and repolarization causing reentrant ventricular arrhythmias. Recently, three-dimensional electro-anatomical mapping (3D EAM) has allowed to investigate the electro-anatomical status of the right ventricle. Radiation exposure during cardiac electrophysiological procedures is still a major concern. We report the first case of 3D mapping of the right ventricle in a postoperative ToF patient performed with a new module of the CARTO® 3 System—the CARTOUnivu™ Module—that combines, simultaneously, fluoroscopic images or cine-angiographic sequences with 3D cardiac mapping to allow real-time visualization of the electrocatheter during the 3D EAM reconstruction. The same volume, previously evaluated with cardiac MRI, was mapped. A perfect match of the diastolic edges of the RV obtained either by cine-loop acquisition during contrast fluoroscopy and by the 3D EAM, was observed. The fluoroscopy time for 3D EAM was 10 s. In conclusion, CARTOUnivu™ Module can integrate, in real time, fluoroscopic images/cine-angiography in virtual biplane view and the 3D EAM allowing a contextual visualization of position and movement of all electrocatheters. This can further increase the accuracy of the 3D EAM in very complex-operated congenital heart diseases, even decreasing radiation exposure.

Original languageEnglish
Pages (from-to)7-9
Number of pages3
JournalInternational Journal of Cardiovascular Imaging
Volume31
Issue number1
DOIs
Publication statusPublished - 2014

Keywords

  • 3D mapping system
  • Congenital heart disease
  • Radiation exposure
  • Ventricular arrhythmias

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

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