Cardiac mapping technology

In general, the methodologies for cardiac electrical mapping entail registration of the electrical activation sequences of the heart by recording extracellular electrograms. The initial use of cardiac mapping was primarily to better understand the normal electrical excitations of the heart. However, the focus in mapping over time has shifted to the study of mechanisms and substrates underlying various arrhythmias; these techniques have been employed to aid in the guidance of curative surgical and/or catheter ablation procedures. More recently, the advent and continued development of high-resolution mapping technologies have considerably enhanced our understanding of rapid, complex, and/or transient arrhythmias that typically cannot be sufficiently characterized with more conventional methodologies. For example, the ability to visualize endocardial structures during electrophysiology procedures has greatly advanced the understanding of complex cardiac arrhythmias in relation to their underlying anatomy. In addition, such technologies provide powerful tools in the subsequent treatment of cardiac patients, particularly with the promise of accurately pinpointing the source of arrhythmias and thereby providing possible curative treatments. This chapter will summarize the most recent developments in catheter navigation and three-dimensional arrhythmia mapping technologies including both intracardiac and noninvasive approaches.