From the Department of Cardiology of the University Hospital Maastricht
(J.L.R.M.S., L.-M.R., C.T., H.J.J.W.), the Netherlands, and The Bruce
Rappaport Faculty of Medicine (S.A.B.-H.), Technion-Israel Institute of
Technology, Haifa, Israel.
Correspondence to Joep L.R.M. Smeets, Department of Cardiology, University Hospital Maastricht, CARIM (Cardiovascular Research, Institute Maastricht), P. Debeyelaan 25, PO Box 5800, Maastricht, Netherlands. E-mail j.smeets{at}cardio.azm.nl
Background—Accurate mapping of the
site of origin and activation sequence of a cardiac arrhythmia
is essential for a successful catheter ablation procedure. To achieve
this, precise and reproducible catheter manipulation is mandatory. The
aim of this study was (1) to assess the accuracy of a new
nonfluoroscopic mapping system in humans and (2) to report the first
result of endocardial activation mapping with this system during sinus
rhythm and several types of supraventricular and
ventricular tachycardias.
Methods and Results—Fifteen patients were studied. 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
mapping system were compared with measurements made with calipers by
four independent investigators using identification marks on the
catheter shaft. 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 ventricle was recorded during sinus
rhythm. Three-dimensional activation maps were constructed in patients
with atrial and ventricular tachycardias and
Wolff-Parkinson-White syndrome.
Conclusions—With this new nonfluoroscopic mapping technique,
accurate positioning of the catheter tip is possible. A
three-dimensional activation map can be reconstructed during sinus
rhythm and during supraventricular and
ventricular tachycardias of different
compartments of the heart.
© 1998 American Heart Association, Inc.
Clinical Investigation and Reports
New Method for Nonfluoroscopic Endocardial Mapping in Humans
Accuracy Assessment and First Clinical Results
Key Words: mapping • arrhythmia • ablation
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