Cardiac Mapping and Navigation

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Cardiac Mapping and Navigation
Submitted by gokulnath G
Applied electronics and Instrumentation
College Of Engineering , Trivandrum

Contents
Introduction
Aim
Carto system
System Components
This system enables
Mapping procedure:
Advantages
Clinical Applications
Limitations
Conclusion

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Introduction:

Newer mapping systems have revolutionized the EP lab. aimed at
improving the resolution
three-dimensional spatial localization,
rapidity of acquisition of cardiac activation maps.

.

Electroanatomical mapping (CARTO System)

The CARTO navigation system calculates the position and orientation of the catheter tip, using three known magnetic sources as references

System Components:

This system enables

tracking of the tip of the mapping catheter within the heart
navigation of the catheter independent of fluoroscopy.
Signals received within the sensor are transmitted along the catheter shaft to the main processing unit.
Mapping procedure:
The reference catheter is introduced

The mapping/ ablation catheter is introduced

Determination of the location and orientation

By moving the catheter inside the heart, enables navigation
Mapping procedure: (cont.)
(6) The mapping catheter is dragged over the endocardium,

(7) sampling the location

(8) The local activation time is then color-coded

(9) superimposed on the anatomical map

Criteria for evaluation of the stability and contact
(1) local activation time stability

(2) location stability

(3) Morphological superpositioning of the intracardaic electrogram recorded on two consecutive beats

(4) Cycle length stability,.
Visualisation of Information
The 3D geometry of the chamber is generated.

Integration to CT scan

Display of conduction velocity
Advantages
The ability to accurately relocate and thus revisit areas of interest

It is capable of creating a voltage map

The ability to register the location of individual RF lesions,

Important cardiac structures be tagged properly, which are avoided during ablation.

The ability to tag previously unsuccessful ablation sites
Clinical Applications of Mapping
(1) CARTO system provides relevant electrophysiological information

(2)It accurately determine the 3-D location and orientation of the ablation catheter

The technology enables

To define the mechanism underlying the arrhythmia,

To design the ablation strategy,

Finally to return accurately to the desired site for the delivery of RF energy

Electroanatomic mapping on CARTO system of focal right atrial tachycardia showing earliest activation (red color) below crista terminalis. LAO 40 projection (Figure 3A) and RAO 30 projection (Figure 3B).

CARTO map of the left atrium during sinus rhythm in a patient undergoing focal atrial fibrillation ablation. The map is in a right lateral projection and shows the position of the three pulmonary veins. Radiofrequency lesions (red dots) are delivered at the ostium of the RSPV for isolation.
Conclusion
The newer mapping system reduces fluoroscopic time for ablation

efficient and safe

These newer mapping systems are useful tool for guiding catheter ablation of unstable arrhythmias.

They are relatively simple and easy to ablate,
REFERENCES:
T.arentz.j.von rosenthal,blum.j.stockinger feasibility and safety of pulmonary vein isolation using a new mapping and navigation circulation, vol.108pp2484-2490,2007

D.corrado, c.basso, l.leoni,b.tokajuk 3d electroanatomic voltage mapping increases accuracy of diagnosing circulation vil.111 pp3042-3050,2008

O.skipa, linear inverse problem of electrocardiogram 2004

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