Catheter Tracking: Filter-Based vs. Learning-Based

Atrial fibrillation is the most common sustained arrhythmia. One important treatment option is radio-frequency catheter ablation (RFCA) of the pulmonary veins attached to the left atrium. RFCA is usually performed under fluoroscopic (X-ray) image guidance. Overlay images computed from pre-operative 3-D volumetric data can be used to add anatomical detail otherwise not visible under X-ray. Unfortunately, current fluoro overlay images are static, i.e., they do not move synchronously with respiratory and cardiac motion. A filter-based catheter tracking approach using simultaneous biplane fluoroscopy was previously presented. It requires localization of a circumferential tracking catheter, though. Unfortunately, the initially proposed method may fail to accommodate catheters of different size. It may also detect wrong structures in the presence of high background clutter. We developed a new learning-based approach to overcome both problems. First, a 3-D model of the catheter is reconstructed. A cascade of boosted classifiers is then used to segment the circumferential mapping catheter. Finally, the 3-D motion at the site of ablation is estimated by tracking the reconstructed model in 3-D from biplane fluoroscopy. We compared our method to the previous approach using 13 clinical data sets and found that the 2-D tracking error improved from 1.0 mm to 0.8 mm. The 3-D tracking error was reduced from 0.8 mm to 0.7 mm.