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<title>Electroanatomic mapping</title>

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<p><b>Electroanatomic mapping</b> is a method of creating a three dimensional model of the <a href="Human_heart" class="mw-redirect" title="Human heart">human heart</a> during <a href="Clinical_cardiac_electrophysiology" title="Clinical cardiac electrophysiology">clinical cardiac electrophysiology</a> procedures.

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<div class="mw-heading mw-heading2"><h2 id="Technology">Technology</h2></div>

<p>The fundamental concept of electroanatomic mapping systems is to localize catheters within the heart in three dimensional space (a sort of "<a href="Global_Positioning_System" title="Global Positioning System">GPS</a>" within the heart). Building a 3-D model of the heart with real-time visualization permits reduction in <a href="Fluoroscopy" title="Fluoroscopy">fluoroscopy</a> use. In addition to 3-D structure, the voltage and timing of signals at each point of the heart is recorded to generate different maps to understand and treat different rhythm disturbances.

</p><p>Each of the three systems utilizes different techniques to localize catheters: <sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup>

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<ul><li>Carto uses a low-intensity magnetic field (5-50 μT) with tri-axial inductors in the tip of the catheters to triangulate the tip based on the sense magnetic field relative to sensors placed on the front and back of the chest. Carto 3 adds emission of electric fields from each unique electrode on a catheter to add more localization information.</li>

<li>EnSite uses three sets of electrodes to induced an electric field in the X, Y, and Z axes and the impedances generated by the electric fields.</li>

<li>Rhythmia uses both impedance and magnetic fields.</li></ul>

<div class="mw-heading mw-heading2"><h2 id="Systems">Systems</h2></div>

<p>There are three electroanatomic mapping systems commercially available.

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<div class="mw-heading mw-heading3"><h3 id="Carto">Carto</h3></div>

<p>Biosense-Webster, a subsidiary of <a href="Johnson_%26_Johnson" title="Johnson & Johnson">Johnson & Johnson</a>, produces a cardiac electrophysiology system called CARTO.<sup id="cite_ref-Macias2016_2-0" class="reference"><a href="#cite_note-Macias2016-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> The system is designed to visualise the real-time calculated position and orientation of a specialised <a href="RF_ablation" class="mw-redirect" title="RF ablation">RF ablation</a> <a href="Catheter" title="Catheter">catheter</a> within the patient's heart in order to minimise <a href="Ionizing_radiation" title="Ionizing radiation">radiation exposure</a> during <a href="Fluoroscopy" title="Fluoroscopy">fluoroscopy</a>, increase the accuracy of targeted RF ablation and reacquisition of <a href="Cardiac_pacing" class="mw-redirect" title="Cardiac pacing">pacing</a> sites for re-<a href="Ablation" title="Ablation">ablation</a>.<sup id="cite_ref-3" class="reference"><a href="#cite_note-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> Its navigation system calculates the position and orientation of the catheter tip, using three known magnetic sources as references. The system uses <a href="Static_magnetic_field" class="mw-redirect" title="Static magnetic field">static magnetic fields</a> that are calibrated and computer controlled. Due to the nature of magnetic fields, the orientation may also be calculated while the tip is stationary. By calculating the strength and orientation of the magnetic fields at a given location, the x,y,z position may be calculated along with the <a href="Roll%2C_pitch%2C_and_yaw" class="mw-redirect" title="Roll, pitch, and yaw">roll, pitch, yaw</a> orientation.<sup id="cite_ref-Macias2016_2-1" class="reference"><a href="#cite_note-Macias2016-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup>

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<div class="mw-heading mw-heading3"><h3 id="Ensite">Ensite</h3></div>

<p><a href="St._Jude_Medical" title="St. Jude Medical">St. Jude Medical</a>, now a part of <a href="Abbott_Laboratories" title="Abbott Laboratories">Abbott</a>, manufactures EnSite family of cardiac mapping systems, the latest edition being EnSite Precision, which allows speedy heart mapping during catheter ablation with better accuracy to be able to treat cardiac rhythm disturbances. <sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup>

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<div class="mw-heading mw-heading3"><h3 id="Rhythmia_/_Opal">Rhythmia / Opal</h3></div>

<p>Rhythmia is a mapping system developed by <a href="Boston_Scientific" title="Boston Scientific">Boston Scientific</a>. It has changed names to Opal. <sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup>

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<div class="mw-heading mw-heading2"><h2 id="Uses_of_electroanatomic_mapping">Uses of electroanatomic mapping</h2></div>

<p>Mapping systems generate three kinds of data:

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<ul><li>geometry of the chamber(s) of the heart based on movement of catheters in space</li>

<li>voltage maps based on the amplitude of <a href="Electrogram" title="Electrogram">electrogram</a> recordings</li>

<li>timing maps ("local activation time" or LAT) based on the relative timing of electrogram recordings at different positions in the heart.</li></ul>

<div class="mw-heading mw-heading2"><h2 id="References">References</h2></div>

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</style><cite id="CITEREFIssa2018" class="citation book cs1">Issa, Ziad (2018). <i>Clinical Arrhythmology and Electrophysiology</i> (3rd ed.). Elsevier. <a href="ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <bdi>0323523560</bdi>.</cite></span>

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<li id="cite_note-Macias2016-2"><span class="mw-cite-backlink">^ <a href="#cite_ref-Macias2016_2-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Macias2016_2-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><cite id="CITEREFMaciasAjijolaShivkumarBuch2016" class="citation book cs1">Macias, Carlos; Ajijola, Olujimi; Shivkumar, Kalyanam; Buch, Eric (2016). "Chapter 7: Electroanatomic mapping systems". In Steinberg, Jonathan S.; Jais, Pierre; Calkins, Hugh (eds.). <i>Practical Guide to Catheter Ablation of Atrial Fibrillation</i> (2nd ed.). Wiley-Blackwell. pp. <span class="nowrap">65–</span>73. <a href="ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <bdi>9781118658505</bdi>.</cite></span>

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<li id="cite_note-3"><span class="mw-cite-backlink"><b><a href="#cite_ref-3">^</a></b></span> <span class="reference-text"><cite id="CITEREFJaïsWeerasooriyaShahHocini2002" class="citation journal cs1">Jaïs, P; Weerasooriya, R; Shah, DC; Hocini, M; Macle, L; Choi, KJ; Scavee, C; Haïssaguerre, M; Clémenty, J (May 2002). <a rel="nofollow" class="external text" href="https://doi.org/10.1016%2FS0008-6363%2802%2900263-8">"Ablation therapy for atrial fibrillation (AF): past, present and future"</a>. <i>Cardiovascular Research</i>. <b>54</b> (2): <span class="nowrap">337–</span>46. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1016%2FS0008-6363%2802%2900263-8">10.1016/S0008-6363(02)00263-8</a></span>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/12062339">12062339</a>.</cite></span>

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<li id="cite_note-4"><span class="mw-cite-backlink"><b><a href="#cite_ref-4">^</a></b></span> <span class="reference-text"><cite id="CITEREFjzagoudis2017" class="citation web cs1">jzagoudis (2017-01-03). <a rel="nofollow" class="external text" href="http://www.dicardiology.com/product/st-jude-medical-announces-fda-clearance-ensite-precision-cardiac-mapping-system">"St. Jude Medical Announces FDA Clearance of EnSite Precision Cardiac Mapping System"</a>. <i>DAIC</i><span class="reference-accessdate">. Retrieved <span class="nowrap">2022-07-03</span></span>.</cite></span>

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<li id="cite_note-5"><span class="mw-cite-backlink"><b><a href="#cite_ref-5">^</a></b></span> <span class="reference-text"><cite id="CITEREFBoston_Scientific" class="citation web cs1">Boston Scientific. <a rel="nofollow" class="external text" href="https://www.bostonscientific.com/us/en/healthcare-professionals/products/mapping-and-navigation-systems/opal-hdx-mapping-system/fp00000293.html">"OPAL HDx™ Mapping System – Cardiac Mapping – Boston Scientific"</a><span class="reference-accessdate">. Retrieved <span class="nowrap">31 January</span> 2025</span>.</cite></span>

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