ADAS-VT

Revealing the structure of fibrotic tissue

ADAS-VT (Automatic Detection of Arrhythmic Substrate) is a product intended for the identification of arrhythmia substrate and the planning of Ventricular Tachycardia (VT) ablation procedures using cardiac MRI.

Case example

ADAS-VT addresses the catheter ablation treatment needs of the electrophysiologist: before, during and after the intervention.

Before the intervention

This case example (courtesy of Dr Antonio Berruezo, Hospital Clínic de Barcelona, Spain) shows the MRI data of a patient with VT. ADAS-VT was used to obtain the LV, RV and aorta, and to detect potential channels in the LV. There are several channels detected (blue area shows border-zone corridor).

During the intervention

The planning data, including the channels and other relevant myocardial information, was exported from ADAS-VT to files in formats accepted by EP navigation system. These files were imported into the catheter navigation system and used as assistance to the electroanatomical mapping and the ablation.

ADAS-VT data for the patient above serves as guide the perform the electroanatomical mapping. The left window shows the EAM data, and right window the ADAS-VT.

After the intervention

ADAS-VT can load data from the EP navigation system and be used to compare MRI information to electro-anatomical data.

Software Information

ADAS-VT is a standalone Windows-based post-processing software solution for cardiac Late Gadolinium-enhanced DICOM images.

Import

  • DICOM Late Gadolinium Enhanced
  • Cardiac MRI data from various sources
  • 2D GRE and 3D NAV GRE
  • Automatic Alignment of 2D GRE slices
  • Inspection of DICOM attributes
  • Preview DICOM images without loading

3D viewer

  • Five ways to view the cardiac anatomy: 3D, 2D, 3D-sync-2D, Multi3D and Multi2D
  • 3D interactive visualization of the myocardium by means of transmural LAYERS
  • 3D-sync-2D: to understand MRI-to-3D Cardiac model correspondence
  • Multi3D: multi-window synchronized view to visualize multiple LAYERS to appreciate transmurality in one screen
  • Multi2D: multi-window view of short-axis
  • Selective 3D visualization of Left Ventricle, Right Ventricle, Aorta & scar Core

Study Storage Database

  • Storage and management of processed studies for later review
  • Search by patient name or ID, or Study name
  • Store multiple studies per patient
  • Exchange ADAS-VT studies between users

ADAS-VT PLUS *

  • Import EP navigation Electro Anatomical Mapping studies for comparison with the MRI ADAS study
  • Multi-window synchronized view for easy comparison between modalities (EAM, MRI…)
  • Quantification of tissue statistics
  • Export of structures (LAYERS, RV, Aorta) to file formats compatible with EP navigation systems
  • Export of CHANNELS to file formats compatible with EP navigation systems
* For Investigational purposes only

Tissue characterization

  • 3D Cardiac Model Segmentation including Left Ventricle, Right Ventricle and Aorta
  • Automatic classification of tissue using selectable imaging thresholds
  • Computation of LAYERS, scar Core, and Tissue Boundaries
  • EP-navigation friendly colour mappings to visualize tissue

Channel detection

  • Automatic transmural detection of border-zone corridors (CHANNELS) for the left ventricle
  • Selective visualization of CHANNELS
  • Display of CHANNEL as either (a) centreline, (b) 3D volume or (c) volume intersecting with LAYERs
  • Quantitative analysis for each CHANNEL (mass)

Export

  • Help guide the ablation by exporting structures (including anatomy, fibrosis information and channels) to formats compatible with EP navigation systems
  • Generation of video showing LAYER transmurality from endo to epicardium
  • Generation of snapshots in standard picture formats to keep a record and share the case

Benefits

Visualize the inside of the myocardium in 3D

Identify optimal ablation targets

Help decide the approach (Endo, Epi, Combined)

Export LV and other structures to formats accepted by navigation systems

Partners

ADAS 3D is developed in partnership with Hospital Clínic de Barcelona, Spain.

Hospital Clínic de Barcelona

Collaborations

ADAS-VT is being evaluated clinically in collaboration with:

Herzzentrum Leipzig, Germany. Prof Gerhard Hindricks, Director of the Department of Electrophysiology • Johns Hopkins Hospital, Baltimore, USA. Prof Henry Halperin, Co-Director, Johns Hopkins Imaging Institute of Excellence • Cardiocentro Ticino, Lugano, Switzerland. Prof Angelo Auricchio, Director of the Heart Failure Program and Clinical Electrophysiology Unit • Hospital of the University of Pennsylvania, Philadelphia, USA. Prof Francis Marchlinski, Director of Electrophysiology Laboratory. Prof Saman Nazarian. Prof Harold Litt, Chief, Cardiovascular Imaging Section, Radiology • INCOR, Sao Paulo, Brazil. Prof Mauricio Scanavacca, Diretor da Unidade Clinica de Arrritmia e Marcapasso • National University Hospital, Singapore. Dr Pipin Kojodjojo, Department of Cardiology • Guglielmo da Saliceto Hospital, Piacenza, Italy. Dr Diego Penela, Department of Cardiology • CEDIMED, Medellin, Colombia. Dr Alejandro Zuluaga, Radiology • St Antonius Ziekenhuis, Nieuwegein, The Netherlands. Prof Lucas Boersma, Head of Cardiology • Coburg Herzzentrum, Germany. Prof Sonia Busch, Leitende Oberärztin für Elektrophysiologie • Hospital Universitario Virgen del Rocio, Seville, Spain. Dr Juan Acosta,Department of Cardiology • Barts Heart Centre, London, UK. Prof Richard Schilling, Director Cardiovascular CAG

See also

ADAS-VT Product ADAS Technology for Ablation Guidance.

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