Validation of a new noncontact catheter system for electroanatomic mappingof left ventricular endocardium

Background-Improvements in cardiac mapping are required to advance our unde rstanding and treatment of arrhythmias. This study validated a new nonconta ct multielectrode array catheter and accompanying analysis system to provid e electroanatomic mapping of the entire left ventricular (LV) endocardium d uring a single beat. Methods and Results-A 9F 64-electrode balloon array catheter with an inflat ed size of 1.8x4.6 cm was used to simultaneously record electrical potentia ls generated by the heart and locate a standard electrophysiology (EP) cath eter within the same chamber. By use of the recorded location of the EP-cat heter tip, LV geometry was determined. Array potentials served as inputs to a high-order boundary-element method to produce 3360 potential points on t he endocardial surface translatable into electrograms or color-coded activa tion maps. Three methods of validation were used: (1) driven electrodes in an in vitro tank were located; (2) waveforms generated from the array cathe ter were compared with catheter contact waveforms in canine LV; and (3) sit es of local LV endocardial activation were located and marked with radiofre quency lesions. Tank testing located a driven electrode to within 2.33+/-0. 44 mm, Correlation of timing and morphology of computed versus contact elec trograms was 0.966, Radiofrequency lesions marked 17 endocardial pacing sit es to within 4.0+/-3.2 mm. Conclusions-This new system provides anatomically accurate endocardial isop otential mapping during a single cardiac cycle. The locator component enabl ed placement of a separate EP catheter to any site within the mapped chambe r.