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(Circulation. 1999;99:829-835.)
© 1999 American Heart Association, Inc.
Basic Science Reports |
Validation of a New Noncontact Catheter System for Electroanatomic Mapping of Left Ventricular Endocardium
From the University of Minnesota, Veterans Affairs Medical Center (C.C.G.), Minneapolis, Minn; St. Paul Heart Clinic (S.W.A.), St. Paul, Minn; and Endocardial Solutions Inc (B.P., J.H., J.B., J.S.), St. Paul, Minn.
Correspondence to Charles C. Gornick, MD, Cardiology 111C VAMC, 1 Veterans Dr, Minneapolis, MN 55417. E-mail gorni002{at}maroon.tc.umn.edu
Background—Improvements in cardiac mapping are required to advance our understanding and treatment of arrhythmias. This study validated a new noncontact multielectrode array catheter and accompanying analysis system to provide electroanatomic mapping of the entire left ventricular (LV) endocardium during a single beat.
Methods and Results—A 9F 64-electrode balloon array catheter with an inflated size of 1.8x4.6 cm was used to simultaneously record electrical potentials generated by the heart and locate a standard electrophysiology (EP) catheter within the same chamber. By use of the recorded location of the EP-catheter tip, LV geometry was determined. Array potentials served as inputs to a high-order boundary-element method to produce 3360 potential points on the endocardial surface translatable into electrograms or color-coded activation maps. Three methods of validation were used: (1) driven electrodes in an in vitro tank were located; (2) waveforms generated from the array catheter were compared with catheter contact waveforms in canine LV; and (3) sites of local LV endocardial activation were located and marked with radiofrequency lesions. Tank testing located a driven electrode to within 2.33±0.44 mm. Correlation of timing and morphology of computed versus contact electrograms was 0.966. Radiofrequency lesions marked 17 endocardial pacing sites to within 4.0±3.2 mm.
Conclusions—This new system provides anatomically accurate endocardial isopotential mapping during a single cardiac cycle. The locator component enabled placement of a separate EP catheter to any site within the mapped chamber.
Key Words: mapping • catheter ablation • arrhythmia • ventricles • electrophysiology
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