Cardiac Mapping: Utility or Futility?

Gupta, Anoop Kumar and Maheshwari, Alok and Thakur, Ranjan and Lokhandwala, Yash Y. (2002) Cardiac Mapping: Utility or Futility? [Journal (Paginated)]

Full text available as:



Cardiac mapping is a broad term that covers several modes of mapping such as body surface,1 endocardial,2 and epicardial3 mapping. The recording and analysis of extracellular electrograms, reported as early as 1915, forms the basis for cardiac mapping.4 More commonly, cardiac mapping is performed with catheters that are introduced percutaneously into the heart chambers and sequentially record the endocardial electrograms with the purpose of correlating local electrogram to cardiac anatomy. These electrophysiological catheters are navigated and localized with the use of fluoroscopy. Nevertheless, the use of fluoroscopy for these purposes may be problematic for a number of reasons, including: 1) the inability to accurately associate intracardiac electrograms with their precise location within the heart; 2) the endocardial surface is invisible using fluoroscopy and the target sites can only be approximated by their relationship with nearby structures such as ribs, blood vessels, and the position of other catheters; 3) due to the limitations of two-dimensional fluoroscopy, navigation is not exact, time consuming, and requires multiple views to estimate the three-dimensional location of the catheter; 4) inability to accurately return the catheter precisely to a previously mapped site; and 5) exposure of the patient and medical team to radiation.

Item Type:Journal (Paginated)
Keywords:Cardiac mapping
Subjects:JOURNALS > Indian Pacing and Electrophysiology Journal
ID Code:4324
Deposited By:Indian Pacing and Electrophysiology, Journal
Deposited On:02 May 2005
Last Modified:11 Mar 2011 08:56

References in Article

Select the SEEK icon to attempt to find the referenced article. If it does not appear to be in cogprints you will be forwarded to the paracite service. Poorly formated references will probably not work.

1. Flowers NC, Horan LG. Body surface potential mapping. In: Zipes DP, Jalife J, 3rd Eds. Cardiac Electrophysiology: From Cell to Bedside. Philadelphia, PA: WB Saunders; 2000: 737- 745.

2. De Bakker JMT, Janse MJ, Van Cappelle FJL, Durrer D. Endocardial mapping by simultaneous recording of endocardial electrograms during cardiac surgery for ventricular aneurysm. J Am Coll Cardiol 1983; 2: 947: 953.

3. Durrer D, Van Dam RT, Freud GE et al: Total excitation of the isolated human heart. Circulation 1970; 41: 899-912.

4. Lewis T, Rothschild MA. The excitatory process in the dog's heart,II: the ventricles. Philos Trans R Soc Lond B Biol Sci 1915; 206: 181-226.

5. Kadish A, Hauck J, Pederson B, et al: Mapping of atrial activation with a non-contact multielectrode catheter in dogs. Circulation 1999; 99: 1906-1913.

6. Schilling RJ, Peters NS, Davies DW: Feasibility of a non-contact catheter for endocardial mapping of human ventricular tachycardia. Circulation 1999; 99: 2543-2552.

7. Klein LS, Miles WM: Ablative therapy for ventricular arrhythmias. Prog Cardiovasc Dis 1995; 37: 225-242.

8. Gepstein L, Hayam G, Ben-Haim SA. A novel method for nonfluoroscopic catheter-based electroanatomical mapping of the heart: in vitro and in vivo accuracy results. Circulation 1997; 95: 1611-1622.

9. Dorostkar PC, Cheng J, Scheinman MM: Electroanatomical mapping and ablation of the substrate supporting intraatrial reentrant tachycardia after palliation for complex congenital heart disease. PACE 1998; 21: 1810-1819.

10. Nadamanee K, Kosar EM: A nonfluoroscopic catheter- based mapping technique to ablate focal ventricular tachycardia. PACE 1998; 21: 1442- 1447.

11. Stevenson WG, Delacretaz E, Friedman PL, et al: Identification and ablation of macroreentrant ventricular tachycardia with the CARTO electroanatomical mapping system. PACE 1998; 21: 1448- 1456.

12. 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.

13. Schmitt C, Zrenner B, Schneider M, et al: Clinical experience with a novel multielectrode basket catheter in right atrial tachycardias. Circulation 1999; 99: 2414-2422.

14. Zrenner B, Ndrepepa G, Schneider M, et al: Computer-assisted animation of atrial tachyarrhythmias recorded with a 64-electrode basket catheter. J Am Coll Cardiol 1999; 34: 2051-2060.

15. Mangrum JM, Haines DE, Dimarco JP, Mounsey JP. 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.

16. Haissaguerre M, Jais P, Shah DC, et al: Right and left radiofrequency catheter therapy of paroxysmal atrial fibrillation. J Cardiovasc Electrophysiol 1996; 7: 1132-1144.

17. DeBakker JM, van Capelle FJ, Janse MJ, et al: Macroreentry in the infarcted human heart: The mechanism of ventricular tachycardias with a "focal" activation pattern. J Am Coll Cardiol 1991; 18: 1005-1014.

18. Rothman SA, Hsia HH, Cossu SF, et al: Radiofrequency catheter ablation of postventricular ventricular tachycardia: Long-term success and the significance of inducible nonclinical arrhythmias. Circulation 1997; 96: 3499-3508.


Repository Staff Only: item control page