Cardiac Mapping Systems

Effect of fluoroscopy frame rate on radiation exposure and in‐hospital outcomes in three‐dimensional electroanatomic mapping guided procedures

“…Minimizing radiation exposure during these procedures can minimize the risks, including malignancies, especially to the physicians and laboratory staff. There is enough evidence that minimizing or eliminating radiation use during electrophysiology procedures is safe and effective 6‐8 …”

“…5 There are three 3D EAM systems now in common clinical use: the Carto system (Biosense Webster, USA), the EnSite system (Abbott, USA), and the Rhythmia (Boston Scientific, USA). 6 Over the years, we have seen a significant improvement in the technology of 3D EAM and the procedural skills of electrophysiologists, which has allowed for minimizing or eliminating the use of fluoroscopy during various electrophysiology procedures. 7,8 Minimizing radiation exposure during these procedures can minimize the risks, including malignancies, especially to the physicians and laboratory staff.…”

Into a Fluoroless Future: an Appraisal of Fluoroscopy-Free Techniques in Clinical Cardiac Electrophysiology

“…These currents are injected from orthogonal electrode pairs and allows for co-localization of the catheter tip based on the resulting potential difference in the recording tip with respect to a reference electrode. Unlike CARTO, with Ensite the chamber geometry can be determined with any catheter with an electrode, and any catheter can be utilized for mapping and recording of intracardiac signals for the voltage and activation map [20,21], which is timed against a fiducial point on reference catheter (similar to CARTO). Advanced activation noncontact mapping is available in some systems and utilizes a multi-electrode mesh that is mounted on a balloon and positioned in the cardiac chamber of interest.…”

“…Advanced activation noncontact mapping is available in some systems and utilizes a multi-electrode mesh that is mounted on a balloon and positioned in the cardiac chamber of interest. Without actually contacting the endocardial surface, myocardial potentials can be reconstructed by recording the cavity potentials allowing for indirect reconstruction of the endocardial potentials and activation patterns [20][21][22].…”

“…While these tools facilitate visualization of anatomy and critical areas of arrhythmia generation, it is essential for the electrophysiologist to determine whether the displayed map is plausible or may be introducing unforeseen errors [20,21,23]. All of these EAM technologies are independent from fluoroscopy and given that trainees are trained in these techniques, are often the primary mechanism for fluoroscopy reduction in the EP lab.…”