![]() This stems in part from the limitations of fluoroscopy and conventional catheter-based mapping techniques to localize arrhythmogenic substrates that are removed from fluoroscopic landmarks and the lack of characteristic electrographic patterns for ablation targets. However, as interest has turned to a broad array of more complex arrhythmias, including some atrial tachycardias (ATs), many forms of intraatrial reentry, most VTs, and atrial fibrillation (AF), ablation of such arrhythmias continues to pose a major challenge. Success in stable arrhythmias with predictable anatomical locations or characteristics identifying endocardial electrograms, such as idiopathic ventricular tachycardia (VT), atrioventricular nodal reentrant tachycardia (AVNRT), atrioventricular reentrant tachycardia (AVRT), or typical atrial flutter (AFL), has approached 90% to 99%. Three-Dimensional Rotational Angiography, 202Ĭonventional radiofrequency (RF) ablation has revolutionized the treatment of many supraventricular as well as ventricular arrhythmias. Stereotaxis Magnetic Navigation System, 183Ĭomputed Tomography and Magnetic Resonance Imaging, 197 High-Resolution Electroanatomic Mapping, 171Ĭhoice of Electroanatomic Mapping System, 175 Importantly, these systems must be used as an adjunctive tool to facilitate mapping and ablation, and the integration of anatomical, electrophysiological, and software information by an experienced physician remains an indispensable prerequisite to accomplish a safe and successful procedure. Recorded data of the catheter location and associated intracardiac electrogram at that location are used to reconstruct in real time a representation of the 3-D geometry of the cardiac chamber, color-coded with relevant electrophysiological information (local activation time and electrogram amplitude), as well as purely anatomical chamber mapping. Additionally, technological advances have allowed remote catheter navigation as well as nonfluoroscopic electromagnetic catheter tracking.Įlectroanatomical mapping systems use novel approaches to determine the 3-D location of the mapping catheter accurately, while local electrograms are acquired using conventional methods. These systems are aimed at improving mapping resolution, three-dimensional (3-D) spatial localization, and rapid acquisition of cardiac activation maps. ![]() Several advanced mapping systems have been developed to overcome some of the limitations of conventional mapping and have offered new insights into arrhythmia mechanisms. This stems in part from the limitations of fluoroscopy and conventional catheter-based mapping techniques to localize arrhythmogenic substrates that are removed from fluoroscopic landmarks and the lack of characteristic electrographic patterns for ablation targets. While conventional mapping techniques, guided by fluoroscopy, have been very successful in guiding mapping and ablation of stable arrhythmias with predictable anatomical locations or characteristics identifying endocardial electrograms, those techniques often are inadequate for more complex atrial and ventricular arrhythmias.
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