Riccardo Fenici, Donatella Brisinda, Maria Pia Ruggieri, Peter Fenici.
Clinical Physiology, Biomagnetism Research Center, Catholic University, Rome, Italy
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Several new catheter methods have been
recently developed, for accurate three-dimensional (3D) electro-anatomical
reconstruction of endocardial activation mapping and for non-fluoroscopic navigation
of EP catheters1,2. All of them are intended to improve intraoperative localization of
arrhythmogenic substrates susceptible of ablation, but cannot be used for both
preoperative non-invasive localization of the arrhythmia and for intraoperative drive
of the mapping catheter on the arrhythmogenic target. On the contrary Magnetic
Source Imaging (MSI) is a contact-less imaging technique which provides both non
invasive localization of focal arrhythmias3-5 and 3D imaging of the tip of an amagnetic
catheter (AC), with a spatial resolution of 2-7 mm6-8. In this paper we describe a new
AC, localizable with the MSI technique into a 3D model of the patient’s heart, designed
for multiple simultaneous monophasic action potential (multi-MAP) recording9-11.
The integration of MSI and AC technologies has the potential for the development of a
novel method for high resolution electrophysiologic mapping directly at the site of
origin of the arrhythmia, based on the “a priori” knowledge of target localization. The
use of our new AC, which records simultaneously four MAPs over an area of 3.14 mm2
enhances the spatial resolution of local mapping and spatial integration of EP
information obtainable with MAP recording11. This might be particularly useful to
identify the mechanisms of focal arrhythmias such as abnormal repolarization
dynamics, local conduction disturbances or afterdepolarization11,12.
Fig. 1: A = MCG localization of two amagnetic catheters (#1 and 2) in the BEM torso model
and in frontal (a), and axial MRI slices [(b) mid-anterior and (c) apex]; B = frontal fuoroscopic imaging
of the tip of the two catheters in the right ventricle; C = Multi-Map recording from catheter #1.
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