Paolo Della Bella, Augusto Pappalardo*, Claudio Tondo, Corrado Carbucicchio, Stefania Riva.
Centro Cardiologico “Monzino”, Istituto di Cardiologia, Universita degli Studi di Milano, * Dipartimento di Cardioscienze, Azienda Ospedaliera S. Camillo-Forlanini, Rome, Italy
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Radiofrequency catheter ablation (RFCA) of ventricular tachycardia (VT)
usually requires prolonged mapping to find the exact location of the diastolic activity critical for maintenance of
the reentry circuit1. Mapping with conventional techniques is frequently prevented by hemodynamic intolerance,
this allowing the feasibility of the procedure in a minority of patients with VT.
A novel non contact mapping system (Endocardial Solutions ESI 3000) is able to detect far-field endocardial
potentials sensed at the surface of a purposely designed multielectrode balloon catheter and, from these
potentials, reconstructs unipolar endocardial electrograms (EGMs) at 3360 points of a single heart chamber.
An isopotential activation map is generated from the simultaneous processing of the signals and is projected
on a virtually reconstructed endocardial surface, this allowing the analysis of endocardial activation pattern.
The possibility of producing complete maps of a single beat of tachycardia and perform an off-line analysis of
the endocardial activation during subsequent sinus rhythm, makes the system potentially useful as a means for
mapping unstable arrhythmias.
The accuracy of reconstruction of the unipolar EGMs both during sinus rhythm (SR) and VT, has been
demonstrated in previous studies2-8.
The present study report the use of non contact mapping system to map and guide subsequent RF ablation of
untolerated VT in 3 patients.
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