Jw. Moorman et al., 3-DIMENSIONAL ENDOCARDIAL MAPPING SYSTEM USING A NOVEL X-RAY IMAGER AND LOCATING CATHETER, Journal of electrocardiology, 27, 1994, pp. 139-145
Percutaneous radiofrequency catheter ablation (RFCA) has a very high s
uccess rate for certain arrhythmias, such as Wolff-Parkinson-White syn
drome and idiopathic ventricular tachycardias in the right ventricular
outflow tract. These arrhythmias are typically characterized by a sin
gle site of arrhythmogenic tissue that is well bounded by anatomic mar
kers. Success rates for RFCA for reentrant ventricular tachycardias, t
achycardias not closely associated with anatomic markers, and those ha
ving larger tissue areas requiring multiple overlapping lesions have b
een significantly lower. An endocardial mapping system is being develo
ped that includes a fluoroscopic imager that scans the field of view w
ith a series of small x-ray beams and electrophysiology catheters modi
fied to include miniature x-ray sensor elements. Preliminary work indi
cates that the accuracy of determining the mapping catheter location r
elative to the reference catheters will be +/-1.5 mm. Substituting a h
ighly accurate three-dimensional coordinate system for anatomic marker
s could improve the success rate of RFCA for complex arrhythmias.