Recent advances in cardiac mapping techniques.

Recently several new mapping modalities have been introduced into clinical electrophysiologic laboratories, including basket catheter mapping, electromagnetic mapping, and noncontact mapping. In addition, intracardiac echocardiography is being used increasingly to visualize important intracardiac structures for catheter ablation. Basket catheter mapping and noncontact mapping are simultaneous mapping devices, whereas electromagnetic mapping is a sequential mapping tool. The new basket-shaped catheters provide up to 64 electrodes mounted on a variable number of splines that encircle the cardiac contour. Animation programs help in identifying the earliest activation and analyzing the activation sequence. Electromagnetic mapping uses low density magnetic fields to navigate the catheter position and to allow nonfluoroscopic mapping and ablation. Sequential recording of intracardiac potentials produces a real-time, color-coded, three-dimensional activation map. Noncontact mapping does not require direct contact with the endocardium and permits the reconstruction of more than 3000 simultaneous computed electrograms via mathematical algorithms. Three-dimensional isopotential maps are generated to visualize the impulse propagation and guide catheter ablation.