Electroanatomic mapping is a method of creating a three dimensional model of the

human heart The heart is a muscular organ found in humans and other animals. This organ pumps blood through the blood vessels. The heart and blood vessels together make the circulatory system. The pumped blood carries oxygen and nutrients to the tiss ...

during clinical cardiac electrophysiology procedures.

Technology

The fundamental concept of electroanatomic mapping systems is to localize catheters within the heart in three dimensional space (a sort of "

GPS The Global Positioning System (GPS) is a satellite-based hyperbolic navigation system owned by the United States Space Force and operated by Mission Delta 31. It is one of the global navigation satellite systems (GNSS) that provide geol ...

" within the heart). Building a 3-D model of the heart with real-time visualization permits reduction in

fluoroscopy Fluoroscopy (), informally referred to as "fluoro", is an imaging technique that uses X-rays to obtain real-time moving images of the interior of an object. In its primary application of medical imaging, a fluoroscope () allows a surgeon to see t ...

use. In addition to 3-D structure, the voltage and timing of signals at each point of the heart is recorded to generate different maps to understand and treat different rhythm disturbances. Each of the three systems utilizes different techniques to localize catheters: * Carto uses a low-intensity magnetic field (5-50 μT) with tri-axial inductors in the tip of the catheters to triangulate the tip based on the sense magnetic field relative to sensors placed on the front and back of the chest. Carto 3 adds emission of electric fields from each unique electrode on a catheter to add more localization information. * EnSite uses three sets of electrodes to induced an electric field in the X, Y, and Z axes and the impedances generated by the electric fields. * Rhythmia uses both impedance and magnetic fields.

Systems

There are three electroanatomic mapping systems commercially available.

Carto

Biosense-Webster, a subsidiary of

Johnson & Johnson Johnson & Johnson (J&J) is an American multinational pharmaceutical, biotechnology, and medical technologies corporation headquartered in New Brunswick, New Jersey, and publicly traded on the New York Stock Exchange. Its common stock is a c ...

, produces a cardiac electrophysiology system called CARTO. The system is designed to visualise the real-time calculated position and orientation of a specialised RF ablation

catheter In medicine, a catheter ( ) is a thin tubing (material), tube made from medical grade materials serving a broad range of functions. Catheters are medical devices that can be inserted in the body to treat diseases or perform a surgical procedure. ...

within the patient's heart in order to minimise

radiation exposure Radiation exposure is a measure of the ionization of air due to ionizing radiation from photons. It is defined as the electric charge freed by such radiation in a specified volume of air divided by the mass of that air. As of 2007, "medical radia ...

during

, increase the accuracy of targeted RF ablation and reacquisition of pacing sites for re-

ablation Ablation ( – removal) is the removal or destruction of something from an object by vaporization, chipping, erosion, erosive processes, or by other means. Examples of ablative materials are described below, including spacecraft material for as ...

. Its navigation system calculates the position and orientation of the catheter tip, using three known magnetic sources as references. The system uses static magnetic fields that are calibrated and computer controlled. Due to the nature of magnetic fields, the orientation may also be calculated while the tip is stationary. By calculating the strength and orientation of the magnetic fields at a given location, the x,y,z position may be calculated along with the roll, pitch, yaw orientation.

Ensite

St. Jude Medical, now a part of Abbott, manufactures EnSite family of cardiac mapping systems, the latest edition being EnSite Precision, which allows speedy heart mapping during catheter ablation with better accuracy to be able to treat cardiac rhythm disturbances.

Rhythmia / Opal

Rhythmia is a mapping system developed by

Boston Scientific Boston Scientific Corporation (BSC), headquartered in Marlborough, Massachusetts and incorporated in Delaware, is an American biotechnology and biomedical engineering firm and multinational manufacturer of medical devices used in interventional ...

. It has changed names to Opal. {{cite web , last1=Boston Scientific , title=OPAL HDx™ Mapping System – Cardiac Mapping – Boston Scientific , url=https://www.bostonscientific.com/us/en/healthcare-professionals/products/mapping-and-navigation-systems/opal-hdx-mapping-system/fp00000293.html , access-date=31 January 2025

Uses of electroanatomic mapping

Mapping systems generate three kinds of data: * geometry of the chamber(s) of the heart based on movement of catheters in space * voltage maps based on the amplitude of

electrogram An electrogram (EGM) is a recording of electrical activity of organs such as the brain and heart, measured by monitoring changes in electric potential. Historically, it also referred to an instrument to measure atmospheric electrical potential. ...

recordings * timing maps ("local activation time" or LAT) based on the relative timing of electrogram recordings at different positions in the heart.

References

Cardiac electrophysiology