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2019 AF Symposium: Common Fluoroscopy Technology Converted to Real-Time 3D Images

Fluoroscopy is a type of medical imaging that shows a continuous 2D X-ray image on a monitor, (like an X-ray movie).

by Steve S. Ryan

Another medical breakthrough at this year’s AF Symposium featured an innovative mapping technology which turns normal fluoroscopy into real-time 3D imagery.

During a live CryoBalloon ablation from Milwaukee, WI, the system was used by Drs. Sabir Jra and Dr. Mohamed Hani of Aurora Health Care.

The Navik 3D Cardiac Mapping System from APN Health was FDA approved in 2016 and was first clinically used in March 2018. Dr. Jra is also the developer.

Real-Time Converting 2D to 3D: How the System Works

Commonly found in most every Electrophysiology lab is equipment for fluoroscopy. It’s a type of medical imaging that shows a continuous 2D X-ray image on a monitor (like an X-ray movie).

Monitor images Navik 3D system

The genius of Dr. Jra’s system is converting the familiar fluoroscopy into 3D real-time images.

The Navik 3D Cardiac Mapping System uses a complex mathematical formula and fast processor calculations to locate any opaque object (such as a catheter or a pulmonary vein opening) within regular X-ray fluoroscopy and turn it into a 3D image.

The Navik system uses real-time 2D, single-plane fluoroscopy images along with body surface ECG data and intracardiac echo signals to create a synchronized, real-time 3D visual map.

Real-Time 3D Images

As AF Symposium attendees watched the live CryoBalloon ablation, the mapping seemed to be very fast. It created and displayed real-time 3D maps of the cardiac chambers during the ablation, though the images appeared somewhat different from images from other 3D mapping systems.

Dr. Jra’s system can be integrated into a normal electrophysiology lab using typical procedure equipment. During the live procedure, his lab looked like other EP labs I’ve seen.

Editor’s Comments
3D Huge Improvement over Fluoroscopy: Dr. Jra’s work is innovative and a true medical breakthrough. It’s incredible—being able to convert, in real-time, fluoroscopic images into 3D images. Any electrophysiologist (EP) using fluoroscopy could, in theory, use Dr. Jra’s system.
Instead of X-ray images which are 2D and not all that clear, 3D images are a potentially huge improvement and would make the EP’s work more easily and clearly viewed.
Easy to Install and Use: The Navik 3D Cardiac Mapping System seems relatively easy and cost-effective to install. It doesn’t require major changes to an existing EP lab. But does require one addition piece of equipment, a body surface ECG system under the patient exam table.
Will 3D Fluoroscopy Become Widely Accepted and Used? Considering how many different excellent mapping and ablation systems are now being used, one wonders if Dr. Jra’s 3D fluoroscopy system will become accepted in today’s A-Fib marketplace, I’ll watch the rollout of the Navik 3D Cardiac Mapping System and report on its progress.
References for this article
Djelmami-Hani, M. Novel Approach to Cardiac 3-D Mapping. EP Lab Digest, Vol 18. Issue 9, Sept. 2018. URL: https://www.eplabdigest.com/novel-approach-cardiac-3d-mapping.

APN Health Receives FDA Clearance for Navik 3D Cardiac Mapping System. Diagnostic and Interventional Cardiology, February 29, 2016. URL: https://www.dicardiology.com/product/apn-health-receives-fda-clearance-navik-3d-cardiac-mapping-system

If you find any errors on this page, email us. Y Last updated: Friday, February 8, 2019

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