ELECTROANATOMICAL MAPPING OF THE HEART - BASIC CONCEPTS AND IMPLICATIONS FOR THE TREATMENT OF CARDIAC-ARRHYTHMIAS

The CARTO electroanatomical mapping system represents a paradigm shift in the ability to map the three-dimensional anatomy of the heart and determine the cardiac electrical activity at any given mapped point. T he system associates anatomical structure and electrophysiological dat a and displays the combined information in an easily readable, visual fashion. The system consists of a roving mapping catheter with small m agnetic sensors in the tip, a fixed sensor that acts as a reference po int, a low magnetic field generating pad, and a data acquisition and d isplay system. When the roving catheter is moved in three-dimensional space, its location in relation to the fixed sensor is monitored by th e system, with a resolution of <1 mm. By gating the acquisition of poi nts in space to the cardiac electrical activity, points that represent both location and electrical activity at that location can be acquire d and displayed on a computer screen. After acquiring a number of poin ts, a three-dimensional representation is constructed, and may be disp layed from any viewing projection. Clinical applications of the system include defining the mechanisms of arrhythmias, designing ablation st rategies, guiding ablations, and improving the safety of mapping and a blation procedures by allowing localization of critical cardiac struct ures such as the atrioventricular node and His bundle. The system hold s the potential to both further our understanding of arrhythmias and i ncrease the safety, efficacy, and efficiency of catheter ablation.