Multipolar endocardial mapping of the right atrium during cardiac catheterization: description of a new technique

“…10,11 Previous simultaneous mapping studies of the intact right atrium (RA) and the left atrium (LA) were limited to the epicardium, 12,13 whereas simultaneous multisite endocardial mapping studies were performed only in the RA. 14,15 Since the description of Bachmann's bundle as the major conduit between the atria, 16,17 little is known about other electrical connections between the RA and LA and their role in the spread of activation, particularly along the septum. Mapping the activation patterns simultaneously on the right and left aspects of the septum and on a beat-by-beat basis enables us to identify regions of electrical linkage between the atria and to better understand their role during normal and abnormal atrial rhythms, which may further improve therapy with catheter ablation or pacing.…”

mentioning

confidence: 99%

Simultaneous Multisite Mapping of the Right and the Left Atrial Septum in the Canine Intact Beating Heart

Sun

Velipasaoglu

et al. 1999

Circulation

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Background-The spread of activation between the right atrium (RA) and left atrium (LA), particularly along the right and left aspects of the interatrial septum, is not clear. Methods and Results-Basket-shaped catheters carrying 64 electrodes were deployed into both the RA and LA of 10 dogs.Position and orientation of the baskets were determined by fluoroscopy and echocardiography. Basket unipolar electrograms were simultaneously recorded in each dog during sinus rhythm, right ventricular pacing, and pacing of the right septum through the basket in the superior and inferior regions. Isochrone maps depicting all aspects of the atria, including the septum, were compared. During sinus rhythm and superior right septal pacing, wave fronts propagated predominantly from superior to inferior regions on both the right and left septum. However, activation of the left septum was delayed compared with the right septum. During right ventricular pacing and inferior right septal pacing, activation of the septum was discordant; 1 wave front propagated rapidly on the right septum from inferior to superior regions, whereas 2 opposing wave fronts originated on the left septum in both the superior and inferior regions. The left septum was activated predominantly by the superior wave front. Activation of the left septum was completed in a significantly shorter time during pacing of the right septum in the inferior region compared with the superior region. Conclusions-In dogs, activation of the right and left aspects of the interatrial septum is discordant. Electrical connections are present between the RA and LA in regions superior as well as inferior to the septum. (Circulation. 1999;100:312-319.)

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“…Jenkins et al [1] described a 25-pole BC (Cordis-Webster, Baldwin Park, CA) that was used for endocardial mapping in the right atrium during sinus rhythm and atrial tachycardia. The authors concluded that the new system fulfilled the reasonable criteria for mapping of atrial arrhythmias and prudently recommended its use in selected patients with complex arrhythmias.…”

Section: Animal Studiesmentioning

confidence: 99%

“…Basket catheters have been used successfully in several experimental animal studies as mapping tools to define atrial [1] and ventricular arrhythmias [2,3•]. Jenkins et al [1] described a 25-pole BC (Cordis-Webster, Baldwin Park, CA) that was used for endocardial mapping in the right atrium during sinus rhythm and atrial tachycardia.…”

Section: Animal Studiesmentioning

confidence: 99%

Recent advances in cardiac mapping techniques

et al. 1999

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Recently several new mapping modalities have been introduced into clinical electrophysiologic laboratories, including basket catheter mapping, electromagnetic mapping, and noncontact mapping. In addition, intracardiac echocardiography is being used increasingly to visualize important intracardiac structures for catheter ablation. Basket catheter mapping and noncontact mapping are simultaneous mapping devices, whereas electromagnetic mapping is a sequential mapping tool. The new basket-shaped catheters provide up to 64 electrodes mounted on a variable number of splines that encircle the cardiac contour. Animation programs help in identifying the earliest activation and analyzing the activation sequence. Electromagnetic mapping uses low density magnetic fields to navigate the catheter position and to allow nonfluoroscopic mapping and ablation. Sequential recording of intracardiac potentials produces a real-time, color-coded, three-dimensional activation map. Noncontact mapping does not require direct contact with the endocardium and permits the reconstruction of more than 3000 simultaneous computed electrograms via mathematical algorithms. Three-dimensional isopotential maps are generated to visualize the impulse propagation and guide catheter ablation.

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Multipolar endocardial mapping of the right atrium during cardiac catheterization: description of a new technique

Abstract: This new system may ultimately assist in mapping simple or complex atrial arrhythmias during cardiac catheterization.

Cited by 49 publications

References 22 publications

Relationship between surface electrocardiogram characteristics and endocardial activation sequence in patients with typical atrial flutter

Relationship between surface electrocardiogram characteristics and endocardial activation sequence in patients with typical atrial flutter

Simultaneous Multisite Mapping of the Right and the Left Atrial Septum in the Canine Intact Beating Heart

Recent advances in cardiac mapping techniques

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