title: Novel noncontact catheter system for endocardial electrical and anatomical imaging.
abstract: The study objective was to integrate noncontact mapping and intracardiac echocardiography (ICE) in a single catheter system that enables both electrical and anatomical imaging of the endocardium. We developed a catheter system on the basis of a 9-F sheath that carried a coaxial 64-electrode lumen-probe on the outside and a central ICE catheter (9 F, 9 MHz) on the inside. The sheath was placed in the right atrium (RA) of 3 dogs, and in the left ventricle (LV) of 3 other dogs. To construct cardiac anatomy, the ICE catheter was pulled back over several beats inside the sheath starting from the tip and two-dimensional tomographic images were continuously acquired. To recover endocardial electrograms, the probe was advanced over the sheath and single-beat noncontact electrograms were simultaneously recorded. Endocardial contact electrodes were placed at select sites for validation as well as for pacing. Three-dimensional electrical-anatomical images reconstructed during sinus and paced rhythms correctly associated RA and LV activation sequences with underlying endocardial anatomy (overall activation error = 3.4 +/- 3.2 ms; overall spatial error = 8.0 +/- 3.5 mm). Therefore, accurate fusion of electrical imaging with anatomical imaging during catheterization is feasible. Integrating single-beat noncontact mapping with ICE provides detailed, three-dimensional electrical-anatomical images of the endocardium, which may facilitate management of arrhythmias.
authors.affiliation: Center for Experimental Cardiac Electrophysiology, Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Liyun
authors.initials: L
authors.lastname: Rao
authors.forename: Renjie
authors.initials: R
authors.lastname: He
authors.forename: Chuxiong
authors.initials: C
authors.lastname: Ding
authors.forename: Dirar S
authors.initials: DS
authors.lastname: Khoury
mesh_terms: D000818:Animals; D006328:Cardiac Catheterization / Q000295:instrumentation / Q000379:methods*; D004285:Dogs; D004452:Echocardiography / Q000379:methods*; D004562:Electrocardiography / Q000379:methods*; D004566:Electrodes; D004594:Electrophysiology; D004699:Endocardium / Q000000981:diagnostic imaging / Q000502:physiology*; D006325:Heart Atria; D006352:Heart Ventricles; D021621:Imaging, Three-Dimensional