#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Non fluoroscopic map techniques in contemporary catheter ablation therapy of dysrhythmias


Authors: P. Olexa;  B. Stančák
Authors‘ workplace: Arytmologické oddelenie Východoslovenského ústavu srdcových a cievnych chorôb, Košice, Slovenská republika, prednosta prim. MUDr. Branislav Stančák, CSc.
Published in: Vnitř Lék 2006; 52(1): 72-79
Category: Review

Overview

Rapid development and clinical introduction of 3D techniques of intracardial mapping significantly extended the possibilities of catheter ablation therapy of dysrhythmias. Contemporary imaging techniques allow precise determination of the source and the way of propagation of dysrhythmia in myocardium, which is an evitable condition of a successful ablation therapy. Although the fluoroscopic image during electrophysiologic examination allows continuous check of the position of catheters in the heart, due to its low resolution it remains just rough estimation of their real position. The objective of the authors of this lucid work was to give a brief characteristic of the basic principles of the activity of 3D mapping systems used nowadays and to approximate their significance and advantages for ablation therapy of individual dysrhythmias in clinical practice.

Key words:
ventricular and atrial dysrhythmias – non fluoroscopic 3D mapping techniques – radio-frequency catheter ablation


Sources

1. Keane D. New catheter ablation techniques for treatment of cardiac arrhythmias. CEPR 2002; 6: 341-346.

2. Lustgarten DL, Keane D, Ruskin J. Cryothermal ablation: Mechanism of tissue injury and current experience in the treatment of tachyarrhythmias. Prog Cardiovasc Dis 1999; 41: 481-498.

3. Schmitt C, Ndrepepa G, Deisenhofer I et al. Recent advances in cardiac mapping techniques. Current Cardiology Reports 1999; I: 149-156.

4. Gepstein L, Evans SJ. Electroanatomical mapping of the heart: basic concepts and implications for the treatment of cardiac arrhythmias. PACE 1998; 21: 1268-1278.

5. Friedman PA. Novel mapping techniques for cardiac electrophysiology. Heart 2002; 87: 575-582.

6. Fiala M, Heinc P, Lukl J. Radiofrekvenční katetrová ablace levostranných skrytých síňokomorových přídatných drah. Bezprostřední a dlouhodobé výsledky při transaortálním přístupu. Vnitř Lék 2000; 46: 92-95.

7. Marchlinski F, Callans D, Gottlieb C et al. Magnetic electroanatomical mapping for ablation of focal atrial tachycardias. PACE 1998; 21: 1621-1635.

8. Shah DC, Jais P, Haissaguerre M et al. Three-dimensional mapping of the common atrial flutter circuit in the right atrium. Circulation 1997; 96: 3904-3912.

9. Kottkamp H, Hugl B, Krauss B et al. Electromagnetic versus fluroscopic mapping of the inferior isthmus for ablation of typical atrial flutter: A prospective randomized study. Circulation 2000; 102: 2082-2086.

10. Kautzner J, Peichl P, Čihák R et al. The spectrum of inter- and intraventricular conduction abnormalities in patients eligible for cardiac resynchronization therapy.

Pacing Clin Electrophysiol 2004; 27: 1105-1112.

11. Kautzner J, Čihák R, Peichl P et al. Catheter ablation of ventricular tachycardia following myocardial infarction using three-dimensional electroanatomical mapping. Pacing Clin Electrophysiol 2003; 26: 342-347.

12. Fiala M, Heinc P, Bulava A et al. Komorové tachyarytmie u pacientů bez strukturálního postižení srdce. Klinické a elektrofyziologické vlastnosti tachyarytmií a dlouhodobé výsledky katétrové ablace. Vnitř Lék 2001; 47: 817-828.

13. Marchlinski FE, Callans DJ, Gottlieb CD et al. Linear ablation lesions for control of unmappable ventricular tachycardia in patients with ischemic and nonischemic cardiomyopathy. Circulation 2000; 101: 1288-1296.

14. Studenčan M. Myocardial viability - clinical aspects. Cardiol 2000; 9: 147-153.

15. Pappone C, Augello G, Santinello V. Atrial fibrillation ablaion. Ital Heart J 2005; 6: 190-199.

16. Khoury DS, Berrier KL, Badruddin SM et al. Three-dimensional electrophysiological imaging of the intact left ventricle using a noncontact multielectrode cavitary probe: study of sinus, paced, and spontaneous premature beats. Circulation 1998; 97: 399-409.

17. Khoury DS, Taccardi B, Lux RL et al. Reconstruction of endocardial potentials and activation sequences from intracavitary probe measurements. Localization of pacing sites and effects of myocardial structure. Circulation 1995; 91: 845-863.

18. Schneider M, Schmitt C. Non-contact-Mapping - ein simultanes räumliches Lokalisationsverfahren in der Diagnostik von Herzrhythmusstörungen. Z Kardiol 2000; 89: Suppl 3: III/177-III/185.

19. Schneider M, Ndrepepa G, Zrenner B et al. Non-contact mapping-guided catheter ablation of atrial fibrillation associated with left atrial ectopy. J Cardiovasc Electrophysiol 2000; 11: 475-479.

20. Schmitt H, Weber S, Schwab JO et al. Diagnosis and ablation of focal right atrial tachycardia using a new high-resolution, non contact mapping system. Am J Cardiol 2001; 87: 1017-1021.

21. Schneider M, Ndrepepa G, Zrenner B et al. Non-contact mapping guided ablation of atrial flutter and enhanced-density mapping of the cavotricuspid isthmus. PACE 2001; 24: 1755-1764.

22. Michael MJ, Haines DE, Dimarco JP et al. Elimination of focal atrial fibrillation with a single radiofrequency ablation: Use of a basket catheter in a pulmonary vein for computerized activation sequence mapping. J Cardiovasc Electrophysiol 2000; 11: 1159-1164.

23. Betts TR, Roberts PR, Allen SA et al. Radiofrequency ablation of idiopathic left ventricular tachycardia at the site of earliest activation as determined by noncontact mapping. Cardiovasc Electrophysiol 2000; 11: 1094-1101.

24. Krum D, Goel A, Hauck A et al. Catheter location, tracking, cardiac chamber Geometry creation and ablation using cutaneous patches. J Interv Card Electrophysiol 2005; 12: 17-22.

25. Wittkampf FH, Wever EF, Vos K et al. LocaLisa - new technique for real-time 3-D localization of regular intracardiac electrodes. Circulation 1999; 99: 1312-1317.

26. Stančák B, Spurný P, Olexa P et al. Navigačný systém Localisa v ablačnej liečbe supraventrikulárnych tachykardií (abstr.). Cardiol 2004; 13: 28S-29S.

27. Wittkampf FHM, Wever EFD, Vos K et. al. Reduction of radiation exposure in the cardiac electrophysiology laboratory. PACE 2000; 23: 1638-1644.

28. Kirchhof P, Loh P, Eckardt L et al. A novel nonfluoroscopic catheter visualization system (LocaLisa) to reduce radiation exposure during catheter ablation of supraventricular tachycardias. Am J Cardiol. 2002; 90: 340-343.

29. Marrouche NF, Beheiry S, Tomassoni G et al. Three-Dimensional Nonfluoroscopic Mapping and Ablation of Inappropriate Sinus Tachycardia. Procedural Strategies and Long-Term Outcome. JACC 2002; 39: 1046-1054.

30. Kottkamp H, Hugl B, Krauss B et al. Electromagnetic versus fluoroscopic mapping of the inferior isthmus for ablation of typical atrial flutter. A prospective randomized study. Circulation 2000; 102: 2082-2086.

31. Inama G, Durin O, Agricola P et al. Pulmonary vein isolation in atrial fibrillation ablation: the role of LocaLisa three-dimensional navigation system. Ital Heart J 2004; 10: Suppl 1 S129-S131.

32. Ernst S, Ouyang F, Löber F et al. Catheter-induced linear lesions in the left atrium in patients with atrial fibrillation. An electroanatomic study. JACC 2003; 42: 1271-1282.

33. Ernst S, Schluter M, Ouyang F et al. Modification of the substrate for maintenance of idiopathic human atrial fibrillation efficacy of radiofrequency ablation using nonfluoroscopic catheter guidance. Circulation 2001; 100: 2085-2092.

34. Goya M, Ouyang F, Ernst S et al. Electroanatomic mapping and catheter ablation of breakthroughs from the right atrium to the superior vena cava in patients with atrial fibrillation. Circulation 2002; 106: 1317-1320.

35. Macle L, Jais P, Scavee P et al. Pulmonary vein disconnection using the LocaLisa three-dimensional nonfluoroscopic catheter imaging system. J Cardiovasc Electrophysiol 2003; 14: 693-697.

36. Jenkins KJ, Walsh EP, Colan SD et al. Multipolar endocardial mapping of the right atrium during cardiac catheterization: description of a new technique. JACC 1993; 22: 1105-1110.

37. Ndrepepa G, Zrenner B, Deisenhofer I et al. Relationship between surface electrogram characteristics and endocardial activation sequence in patients with typical atrial flutter. Z Kardiol 2000; 89: 527-537.

38. Eldar M, Ohad DG, Goldberger JJ et al. Transcutaneous multielectrode basket catheter for endocardial mapping and ablation of ventricular tachycardia in the pig. Circulation 1997; 96: 2430-2437.

39. Greenspon AJ, Hsu SS, Datorre S. Successful radiofrequency catheter ablation of sustained ventricular tachycardia post myocardial infarction in man guided by a multielectrode „basket“ catheter. J Cardiovasc Electrophysiol 1997; 8: 565-570.

40. Schalij MJ, van Rugge FP, Siezenga M et al. Endocardial activation mapping of ventricular tachycardia in patients: first application of a 32-site bipolar mapping electrode catheter. Circulation 1998; 98: 2168-2179.

41. Aiba T, Shimuzu W, Taguchi A et al. Clinical usefulness of a multielectrode basket catheter for idiopathic ventricular tachycardia originating from right ventricular outflow tract. J Cardiovasc Electrophysiol 2001; 12: 511-551.

42. De Groot N, Bootsma M, van der Velde ET et al. Three-dimensional catheter positioning during radiofrequncy ablation in patients: First application of the real-time position mangament system. J Cardiovasc Electrophysiol 2000; 11: 1183-1192.

43. Spitzer SG, Karolyi L, Rammler C et al. Ablation of typical atrial flutter using a three-dimensional ultrasound mapping system. J Interv Card Electrophysiol 2003; 8:181-185.

44. Schreieck J, Ndrepepa G, Zrenner B et al. Radiofrequency ablation of cardiac arrhythmias using a three-dimensional real-time position management and mapping system. PACE 2002; 25: 1699-1707.

45. Ernst S, Ouyang F, Linder Ch et al. Initial experience with remote cathether ablation using a novel magnetic navigation system. Circulation 2004; 109: 1472-1475.

46. Tomassoni G. Magnetic Navigation in the EP Lab is now a reality. EP Lab Digest May 2003; 3: 1-4.

47. Faddis MN, Blume W, Finney B et al. Novel, magnetically guided cathether for endocardial mapping and radiofrequency cathether ablation. Circulation 2002; 106: 2980-2985.

Labels
Diabetology Endocrinology Internal medicine

Article was published in

Internal Medicine

Issue 1

2006 Issue 1

Most read in this issue
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#