NEW METHOD FOR NONFLUOROSCOPIC ENDOCARDIAL MAPPING IN HUMANS - ACCURACY ASSESSMENT AND FIRST CLINICAL-RESULTS

Background-Accurate mapping of the site of origin and activation seque nce of a cardiac arrhythmia is essential for a successful catheter abl ation procedure. To achieve this, precise and reproducible catheter ma nipulation is mandatory. The aim of this study was (1) to assess the a ccuracy of a new nonfluoroscopic mapping system in humans and (2) to r eport the first result of endocardial activation mapping with this sys tem during sinus rhythm and several types of supraventricular and vent ricular tachycardias. Methods and Results-Fifteen patients were studie d. Accuracy measurements were performed in 5 of them (patients 5, 6, 7 , 8, and 14), The distances between two subsequent catheter positions in the inferior caval vein as determined by the nonfluoroscopic mappin g system were compared with measurements made with calipers by four in dependent investigators using identification marks on the catheter sha ft. The difference between these two methods was 0.95+/-0.8 mm. In 15 patients, activation of the right atrium and/or the right or left vent ricle was recorded during sinus rhythm. Three-dimensional activation m aps were constructed in patients with atrial and ventricular tachycard ias and Wolff-Parkinson-White syndrome. Conclusions-With this new nonf luoroscopic mapping technique, accurate positioning of the catheter ti p is possible. A three-dimensional activation map can be reconstructed during sinus rhythm and during supraventricular and ventricular tachy cardias of different compartments of the heart.