Navigation for fluoroscopy-guided cryo-balloon ablation procedures of atrial fibrillation

Atrial fibrillation (AF), the most common arrhythmia, has been identified as a major cause of stroke. The current standard in interventional treatment of AF is the pulmonary vein isolation (PVI). PVI is guided by fluoroscopy or non-fluoroscopic electro-anatomic mapping systems (EAMS). Either classic point-to-point radio-frequency (RF) catheter ablation or so-called single-shot-devices like cryo-balloons are used to achieve electrical isolation of the pulmonary veins and the left atrium (LA). Fluoroscopy-based systems render overlay images from pre-operative 3-D data sets which are then merged with fluoroscopic imaging, thereby adding detailed 3-D information to conventional fluoroscopy. EAMS provide tracking and visualization of RF catheters by means of electro-magnetic tracking. Unfortunately, current navigation systems, fluoroscopy-based or EAMS, do not provide tools to localize and visualize single-shot-devices like cryo-balloon catheters in 3-D. We present a prototype software for fluoroscopy-guided ablation procedures that is capable of superimposing 3-D datasets as well as reconstructing cyro-balloon catheters in 3-D. The 3-D cyro-balloon reconstruction was evaluated on 9 clinical data sets, yielding a reprojected 2-D error of 1.72 mm ± 1.02 mm