Registration of 3D computed tomographic images with interventional systems: Implications for catheter ablation of atrial fibrillation

Despite the great promise catheter ablation offers in the treatment of complex arrhythmias such as atrial fibrillation (AF), long procedure times and somewhat suboptimal results hinder the widespread use of this technique. As fluoroscopy does not provide contrast differentiation between the area of interest and the surrounding structures, there is a lack of proper intra procedure image guidance. Segmentation of anatomical structures such as the left atrium (LA) can be performed using images obtained with modalities such as computed tomography (CT). However, unlike the cardiac mapping systems, these imaging systems do not track catheters in real time. This review addresses the evolving concept of image registration to deliver therapy in cardiac arrhythmias.