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Non-fluoroscopic Imaging with MRT/CT Image Integration - Catheter Positioning with Double Precision
(2014)
Introduction: When antiarrhythmic drug therapy has failed, different approaches of pulmonary vein isolation are considered a reasonable option in the treatment of atrial fibrillation. It will be performed predominantly by radiofrequency catheter ablation. As the individual anatomy of left atrium and the pulmonary veins differs considerably, accurate visualization of these structures is essential during catheter positioning. Using non-fluoroscopic electroanatomic mapping system with image integration, electroanatomic mapping can be combined with highly detailed anatomical MRT or CT information on complex left atrial structures. This may facilitate catheter navigation during ablation for atrial fibrillation.
Methods: The CARTO XP electroanatomic system was used in a project during biomedical engineering study to practice image integration of anonymized real patients that underwent pulmonary vein isolation by CARTO XP and a MRT/CT procedure. Using the image integration software, MRT or CT images were imported into the CARTO XP system. The next process was segmentation of the acquired images. It involves dividing the images into different regions in order to select the structures of interest. In clinical routine, this segmentation has to be performed before catheter ablation. Then, the segmented images were aligned with the reconstructed electroanatomic maps. This consists of several steps, including selection of the left atrium, scaling of the reconstructed geometry, fusion of the structures using landmarks, and optimization of the integration by adjusting the reconstructed geometry of the left atrium.
Results: In the 3 months lasting period of the project, image integration was trained in 13 patients undergoing catheter ablation for atrial fibrillation. Within this period, time consumption for the process decreased from about 90 minutes at the beginning to about 35 minutes at the end for one patient.
Conclusion: Image integration into non-fluoroscopic electroanatomic map is a sophisticated tool in cardiac radiofrequency catheter ablation. Intensive training is necessary to control the procedure.
Automatic Meter Reading (AMR) is a major enabler for the upcoming smart grid. Potentially, it will be one of the first really large-scale M2M-communication solutions for sensor applications.
To date, the definition of the standardized communication stacks for Local Metrological Network (LMN) in AMR is still ongoing. This holds true both for ZigBee Smart Energy Profile and for Wireless M-Bus according to EN 13757. During this process, there is the necessity for flexible, albeit optimized solutions, which support the different existing and upcoming versions of the communication protocols. In the case of Wireless M-Bus, the major contender for European and possibly Asian installations, this is valid not only for the different operation modes (C-, N-, P-, Q-, R-, S-, and T-modes), which work in different frequencies (i.e. 868 MHz, 433 MHz, and 169 MHz) but also for the application layer, where additional bodies, like EN137575, Open Metering System (OMS) Group, or national bodies follow their approaches.
This contribution describes requirements, design techniques and experiences from the development of highly efficient Wireless M-Bus protocol stacks with support of good flexibility and portability between microcontroller platforms and RF-transceivers. The presented approach is not limited to the use of modern software engineering design processes, as such, but also includes essential additional features like testing or simulation, as well as tools for commissioning and monitoring.
Ranging errors are inevitable in all local positioning systems, including those based on Time-of-Flight (ToF) technique. Results of experiments show that the major cause for these errors is a signal degradation from multipath propagation. This effect is especially critical in case of Non-Light-of-Sight (NLOS) conditions. This paper describes causes that affects ranging errors for nanoLOC™-TOF-technology and presents estimations for the probability density functions of such errors under different NLOS conditions. The provided estimations allow the improvement of the accuracy of the localization through the subsequent mitigation of the ranging errors from the measurements. Additionally, it is proposed to increase the number of cases of NLOS-conditions for the improvement of the accuracy.
Efficient, low-cost, secure and reliable communication solutions are a major stepping stone for smart metering and smart grid applications. This especially holds true for the so called primary communication or local metrological network (LMN) between a local meter or actuator and a data collector or gateway, where the highest requirements with regard to cost, bandwidth, and energy efficiency have to be taken into consideration. Multiple developments and field tests are going on in this field, however, energy autarkic devices are hardly found, yet.
Efficient, low-cost, secure and reliable communication solutions are a major stepping stone for smart metering and smart grid applications. This especially holds true for the so called primary communication or local metrological network (LMN) between a local meter or actuator and a data collector or gateway, where the highest requirements with regard to cost, bandwidth, and energy efficiency have to be taken into consideration. Multiple developments and field tests are going on in this field, however, energy autarkic devices are hardly found, yet. This contribution describes the development of an automatic water meter reading (AWMR) technology based on Wireless M-Bus to provide water utility companies with an automatic remote water meter reading solution. It addresses the special needs of home utilities by providing a remote metering solution independent from the electricity infrastructure, both in terms of data communication and in terms of power supply. For this project, a cost efficient integrated energy harvesting system powered by the available water flow was developed, to enable operation independently of the mains grid, and eliminate the need for battery replacement for near-zero maintenance costs.
The communication technologies for automatic meter reading (smart metering) and for energy production and distribution networks (smart grid) have the potential to be one of the first really highly scaled machine-to-machine-M2M-applications. During the last years, two very promising developments around the wireless part of the smart grid communication were initialized, which possibly could have an impact on the network architectures and the markets far beyond Germany and far beyond energy automation. Besides the specification of the OMS Group of a security extension to the Wireless M-Bus protocol (EN13757-4), the German Federal Office for Information Security (Bundesamt für Sicherheit in der Informationstechnik, BSI) has designed a Protection Profile (PP) and a Technical Directive (TR) for the communication unit of an intelligent measurement system (Smart Meter Gateway), which were released in March 2013. This design uses state of the art technologies and prescribes their implementation in real-life systems. At first, the proposed paper will present the most important characteristics of this architecture. It will then give an insight into the implementation of the OMS security protocols, which imply the usage of a mutually authenticated SSL protocol also in the Local Metrological Network. This is achieved with the help of an additional Authentication and Fragmentation Layer (AFL). This secure communication will be terminated in a BSI conformant secure smart meter gateway, which is developed in a different project and described in the second step. Finally, the contribution will discuss the integration of such a metering network into an overall telecommunication network and PKI infrastructure.