Catheter location, tracking, cardiac chamber geometry creation, and ablation using cutaneous patches.
OBJECTIVE
The ability to construct a three-dimensional (3-D) surface model of the endocardium and track the location of catheters within a cardiac chamber, using only cutaneous patches, would be a useful advancement in treating arrhythmias. We tested the feasibility of such a system, Ensite NavX (Endocardial Solutions, Inc., St. Paul, MN, USA), in patients undergoing catheter ablation for SVTs.


METHODS
Sixteen patients with 20 arrhythmias undergoing ablation were selected. Skin electrode patches were placed on the chest to create a 3-D coordinate system. A low-amplitude, 5.7 kHz signal emitted from the patches was received by conventional catheters positioned in the heart. Catheter location was determined by measuring the field strength received by the catheters. Location points were successively acquired while catheters were moved throughout the chamber. This information was collected and processed by a workstation to create a detailed 3-D model of the endocardial surface. Anatomic landmarks were labeled on the model as the mapping catheter was navigated. 3-D cardiac chamber geometry reconstruction, landmark labeling, and real time catheter tracking were performed successfully in all patients. Up to six catheters, with a total of up to 26 intracardiac electrodes, were tracked simultaneously.


RESULTS
Constructed geometries, including major vessels and valves, correlated closely with traditional anatomic models as well as intracardiac recordings and fluoroscopic images.


CONCLUSIONS
Real-time catheter tracking and 3-D cardiac chamber model construction is feasible using cutaneous patches and conventional catheters. This approach may be useful in the treatment of patients with cardiac arrhythmias where ablation therapy is primarily anatomically based.
Krum
David
D
Electrophysiology Laboratories of Aurora Sinai and St. Luke's Medical Centers, University of Wisconsin Medical School-Milwaukee Clinical Campus, Milwaukee, Wisconsin, USA.
Goel
Anil
A
Hauck
John
J
Schweitzer
Jeff
J
Hare
John
J
Attari
Mehran
M
Dhala
Anwer
A
Cooley
Ryan
R
Akhtar
Masood
M
Sra
Jasbir
J
D000328:Adult; D000368:Aged; D018780:Body Surface Potential Mapping / Q000379:methods*; D017115:Catheter Ablation; D004562:Electrocardiography / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006325:Heart Atria / Q000503:physiopathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013617:Tachycardia, Supraventricular / Q000503:physiopathology / Q000601:surgery*
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