Data fusion of left ventricle Electro-Anatomic Mapping and Multislice Computerized Tomography for Cardiac Resynchronisation Therapy optimization

Cardiac Resynchronization Therapy is a treatment for bi-ventricular asynchronism. It can be optimized by the identification of the most effective pacing sites. The aim of this study is to provide a helpful tool to perform this identification by the fusion of electrical and anatomical information resulting from Electro-Anatomic Mapping (EAM) data and Multislice Computerized Tomography (MSCT) imaging. EAM data provide an approximation of the left ventricle (LV) 3D-surface (SEAM). Left cardiac chambers are segmented from MSCT imaging and surfaces are reconstructed (SCT). In order to represent this information in a unified framework, a three steps method is proposed: (1) the LV is separated from the left auricle on SCT providing S´_CT; (2) a semi-automatic rigid registration method is applied to SEAM and S´_CT; (3) activation time delays are estimated on S´_CT from the EAM data. This method results in a graphical interface offering to clinicians means to identify abnormal electrical activity sites.