Validation of a novel CARTOSEG™ segmentation module software for contrast-enhanced computed tomography-guided radiofrequency ablation in patients with atrial fibrillation

Hasan Imanli, Shaun Bhatty, Jean Jeudy, Yousra Ghzally, Kiddy Ume, Ramarao Vunnam, Refael Itah, Mati Amit, John Duell, Vincent See, Stephen Shorofsky, Timm M. Dickfeld

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Introduction: Visualization of left atrial (LA) anatomy using image integration modules has been associated with decreased radiation exposure and improved procedural outcome when used for guidance of pulmonary vein isolation (PVI) in atrial fibrillation (AF) ablation. We evaluated the CARTOSEG™ CT Segmentation Module (Biosense Webster, Inc.) that offers a new CT-specific semiautomatic reconstruction of the atrial endocardium. Methods: The CARTOSEG™ CT Segmentation Module software was assessed prospectively in 80 patients undergoing AF ablation. Using preprocedural contrast-enhanced computed tomography (CE-CT), cardiac chambers, coronary sinus (CS), and esophagus were semiautomatically segmented. Segmentation quality was assessed from 1 (poor) to 4 (excellent). The reconstructed structures were registered with the electroanatomic map (EAM). PVI was performed using the registered 3D images. Results: Semiautomatic reconstruction of the heart chambers was successfully performed in all 80 patients with AF. CE-CT DICOM file import, semiautomatic segmentation of cardiac chambers, esophagus, and CS was performed in 185 ± 105, 18 ± 5, 119 ± 47, and 69 ± 19 seconds, respectively. Average segmentation quality was 3.9 ± 0.2, 3.8 ± 0.3, and 3.8 ± 0.2 for LA, esophagus, and CS, respectively. Registration accuracy between the EAM and CE-CT-derived segmentation was 4.2 ± 0.9 mm. Complications consisted of one perforation (1%) which required pericardiocentesis, one increased pericardial effusion treated conservatively (1%), and one early termination of ablation due to thrombus formation on the ablation sheath without TIA/stroke (1%). All targeted PVs (n = 309) were successfully isolated. Conclusions: The novel CT- CARTOSEG™ CT Segmentation Module enables a rapid and reliable semiautomatic 3D reconstruction of cardiac chambers and adjacent anatomy, which facilitates successful and safe PVI.

Original languageEnglish (US)
Pages (from-to)1206-1212
Number of pages7
JournalPACE - Pacing and Clinical Electrophysiology
Volume40
Issue number11
DOIs
StatePublished - Nov 1 2017

Fingerprint

Coronary Sinus
Pulmonary Veins
Atrial Fibrillation
Esophagus
Software
Tomography
Anatomy
Pericardiocentesis
Endocardium
Pericardial Effusion
Thrombosis
Stroke

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Imanli, Hasan ; Bhatty, Shaun ; Jeudy, Jean ; Ghzally, Yousra ; Ume, Kiddy ; Vunnam, Ramarao ; Itah, Refael ; Amit, Mati ; Duell, John ; See, Vincent ; Shorofsky, Stephen ; Dickfeld, Timm M. / Validation of a novel CARTOSEG™ segmentation module software for contrast-enhanced computed tomography-guided radiofrequency ablation in patients with atrial fibrillation. In: PACE - Pacing and Clinical Electrophysiology. 2017 ; Vol. 40, No. 11. pp. 1206-1212.
@article{a65120dfb346420da894fb4acd7e5437,
title = "Validation of a novel CARTOSEG™ segmentation module software for contrast-enhanced computed tomography-guided radiofrequency ablation in patients with atrial fibrillation",
abstract = "Introduction: Visualization of left atrial (LA) anatomy using image integration modules has been associated with decreased radiation exposure and improved procedural outcome when used for guidance of pulmonary vein isolation (PVI) in atrial fibrillation (AF) ablation. We evaluated the CARTOSEG™ CT Segmentation Module (Biosense Webster, Inc.) that offers a new CT-specific semiautomatic reconstruction of the atrial endocardium. Methods: The CARTOSEG™ CT Segmentation Module software was assessed prospectively in 80 patients undergoing AF ablation. Using preprocedural contrast-enhanced computed tomography (CE-CT), cardiac chambers, coronary sinus (CS), and esophagus were semiautomatically segmented. Segmentation quality was assessed from 1 (poor) to 4 (excellent). The reconstructed structures were registered with the electroanatomic map (EAM). PVI was performed using the registered 3D images. Results: Semiautomatic reconstruction of the heart chambers was successfully performed in all 80 patients with AF. CE-CT DICOM file import, semiautomatic segmentation of cardiac chambers, esophagus, and CS was performed in 185 ± 105, 18 ± 5, 119 ± 47, and 69 ± 19 seconds, respectively. Average segmentation quality was 3.9 ± 0.2, 3.8 ± 0.3, and 3.8 ± 0.2 for LA, esophagus, and CS, respectively. Registration accuracy between the EAM and CE-CT-derived segmentation was 4.2 ± 0.9 mm. Complications consisted of one perforation (1{\%}) which required pericardiocentesis, one increased pericardial effusion treated conservatively (1{\%}), and one early termination of ablation due to thrombus formation on the ablation sheath without TIA/stroke (1{\%}). All targeted PVs (n = 309) were successfully isolated. Conclusions: The novel CT- CARTOSEG™ CT Segmentation Module enables a rapid and reliable semiautomatic 3D reconstruction of cardiac chambers and adjacent anatomy, which facilitates successful and safe PVI.",
author = "Hasan Imanli and Shaun Bhatty and Jean Jeudy and Yousra Ghzally and Kiddy Ume and Ramarao Vunnam and Refael Itah and Mati Amit and John Duell and Vincent See and Stephen Shorofsky and Dickfeld, {Timm M.}",
year = "2017",
month = "11",
day = "1",
doi = "10.1111/pace.13189",
language = "English (US)",
volume = "40",
pages = "1206--1212",
journal = "PACE - Pacing and Clinical Electrophysiology",
issn = "0147-8389",
publisher = "Wiley-Blackwell",
number = "11",

}

Validation of a novel CARTOSEG™ segmentation module software for contrast-enhanced computed tomography-guided radiofrequency ablation in patients with atrial fibrillation. / Imanli, Hasan; Bhatty, Shaun; Jeudy, Jean; Ghzally, Yousra; Ume, Kiddy; Vunnam, Ramarao; Itah, Refael; Amit, Mati; Duell, John; See, Vincent; Shorofsky, Stephen; Dickfeld, Timm M.

In: PACE - Pacing and Clinical Electrophysiology, Vol. 40, No. 11, 01.11.2017, p. 1206-1212.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Validation of a novel CARTOSEG™ segmentation module software for contrast-enhanced computed tomography-guided radiofrequency ablation in patients with atrial fibrillation

AU - Imanli, Hasan

AU - Bhatty, Shaun

AU - Jeudy, Jean

AU - Ghzally, Yousra

AU - Ume, Kiddy

AU - Vunnam, Ramarao

AU - Itah, Refael

AU - Amit, Mati

AU - Duell, John

AU - See, Vincent

AU - Shorofsky, Stephen

AU - Dickfeld, Timm M.

PY - 2017/11/1

Y1 - 2017/11/1

N2 - Introduction: Visualization of left atrial (LA) anatomy using image integration modules has been associated with decreased radiation exposure and improved procedural outcome when used for guidance of pulmonary vein isolation (PVI) in atrial fibrillation (AF) ablation. We evaluated the CARTOSEG™ CT Segmentation Module (Biosense Webster, Inc.) that offers a new CT-specific semiautomatic reconstruction of the atrial endocardium. Methods: The CARTOSEG™ CT Segmentation Module software was assessed prospectively in 80 patients undergoing AF ablation. Using preprocedural contrast-enhanced computed tomography (CE-CT), cardiac chambers, coronary sinus (CS), and esophagus were semiautomatically segmented. Segmentation quality was assessed from 1 (poor) to 4 (excellent). The reconstructed structures were registered with the electroanatomic map (EAM). PVI was performed using the registered 3D images. Results: Semiautomatic reconstruction of the heart chambers was successfully performed in all 80 patients with AF. CE-CT DICOM file import, semiautomatic segmentation of cardiac chambers, esophagus, and CS was performed in 185 ± 105, 18 ± 5, 119 ± 47, and 69 ± 19 seconds, respectively. Average segmentation quality was 3.9 ± 0.2, 3.8 ± 0.3, and 3.8 ± 0.2 for LA, esophagus, and CS, respectively. Registration accuracy between the EAM and CE-CT-derived segmentation was 4.2 ± 0.9 mm. Complications consisted of one perforation (1%) which required pericardiocentesis, one increased pericardial effusion treated conservatively (1%), and one early termination of ablation due to thrombus formation on the ablation sheath without TIA/stroke (1%). All targeted PVs (n = 309) were successfully isolated. Conclusions: The novel CT- CARTOSEG™ CT Segmentation Module enables a rapid and reliable semiautomatic 3D reconstruction of cardiac chambers and adjacent anatomy, which facilitates successful and safe PVI.

AB - Introduction: Visualization of left atrial (LA) anatomy using image integration modules has been associated with decreased radiation exposure and improved procedural outcome when used for guidance of pulmonary vein isolation (PVI) in atrial fibrillation (AF) ablation. We evaluated the CARTOSEG™ CT Segmentation Module (Biosense Webster, Inc.) that offers a new CT-specific semiautomatic reconstruction of the atrial endocardium. Methods: The CARTOSEG™ CT Segmentation Module software was assessed prospectively in 80 patients undergoing AF ablation. Using preprocedural contrast-enhanced computed tomography (CE-CT), cardiac chambers, coronary sinus (CS), and esophagus were semiautomatically segmented. Segmentation quality was assessed from 1 (poor) to 4 (excellent). The reconstructed structures were registered with the electroanatomic map (EAM). PVI was performed using the registered 3D images. Results: Semiautomatic reconstruction of the heart chambers was successfully performed in all 80 patients with AF. CE-CT DICOM file import, semiautomatic segmentation of cardiac chambers, esophagus, and CS was performed in 185 ± 105, 18 ± 5, 119 ± 47, and 69 ± 19 seconds, respectively. Average segmentation quality was 3.9 ± 0.2, 3.8 ± 0.3, and 3.8 ± 0.2 for LA, esophagus, and CS, respectively. Registration accuracy between the EAM and CE-CT-derived segmentation was 4.2 ± 0.9 mm. Complications consisted of one perforation (1%) which required pericardiocentesis, one increased pericardial effusion treated conservatively (1%), and one early termination of ablation due to thrombus formation on the ablation sheath without TIA/stroke (1%). All targeted PVs (n = 309) were successfully isolated. Conclusions: The novel CT- CARTOSEG™ CT Segmentation Module enables a rapid and reliable semiautomatic 3D reconstruction of cardiac chambers and adjacent anatomy, which facilitates successful and safe PVI.

UR - http://www.scopus.com/inward/record.url?scp=85033715082&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85033715082&partnerID=8YFLogxK

U2 - 10.1111/pace.13189

DO - 10.1111/pace.13189

M3 - Article

C2 - 28901573

AN - SCOPUS:85033715082

VL - 40

SP - 1206

EP - 1212

JO - PACE - Pacing and Clinical Electrophysiology

JF - PACE - Pacing and Clinical Electrophysiology

SN - 0147-8389

IS - 11

ER -