Background-Improvements in cardiac mapping are required to advance our understanding and treatment of arrhythmias.This study validated a new noncontact multielectrode array catheter and accompanying analysis system to provide electroanatomic mapping of the entire left ventricular (LV) endocardium during a single beat. Methods and Results-A 9F 64-electrode balloon array catheter with an inflated size of 1.8ϫ4.6 cm was used to simultaneously record electrical potentials generated by the heart and locate a standard electrophysiology (EP) catheter within the same chamber. By use of the recorded location of the EP-catheter tip, LV geometry was determined. Array potentials served as inputs to a high-order boundary-element method to produce 3360 potential points on the endocardial surface translatable into electrograms or color-coded activation maps. Three methods of validation were used: (1) driven electrodes in an in vitro tank were located; (2) waveforms generated from the array catheter were compared with catheter contact waveforms in canine LV; and (3)

Propose High-fidelity 12-lead Electrocardiogram (ECG) is important for physiological monitoring of patients during MR-guided intervention and cardiac MR imaging. Issues in obtaining non-corrupted ECGs inside MRI include a superimposed Magneto-Hydro-Dynamic (MHD) voltage, gradient-switching induced-voltages, and radiofrequency (RF) heating. These problems increase with magnetic field. We intended to develop and clinically validate a 1.5T MRI-conditional 12-lead ECG system. Methods The system was constructed, including transmission-lines to reduce radio-frequency induction, and switching-circuits to remove induced voltages. Adaptive filters, trained by 12-lead measurements outside MRI and in two orientations inside MRI, were used to remove MHD. The system was tested on ten (one exercising) volunteers and four arrhythmia patients. Results Switching circuits removed most imaging-induced voltages (residual noise <3% of the R-wave). MHD removal provided intra-MRI ECGs that varied by <3.8% from those outside the MRI, preserving the true ST segment. In premature-ventricular-contraction (PVC) patients, clean ECGs separated PVC and sinus-rhythm beats. Measured heating was <1.5 C0. The system reliably acquired multiphase (SSFP) wall-motion-cine and phase-contrast-cine scans, including in subjects where 4-lead gating failed. The system required a minimum TR of 4ms to allow robust ECG processing. Conclusion High-fidelity intra-MRI 12-lead ECG is possible.

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