A nonfluoroscopic catheter-based mapping technique to ablate focal ventricular tachycardia.

The recent introduction of a nonfluoroscopic electroanatomical cardiac mapping system (CARTO) is an exciting development in catheter ablation treatment of cardiac arrhythmias. The system uses ultralow magnetic fields to locate a sensor positioned near the tip of a regular mapping and ablation catheter. The catheter location and electrograms are recorded and reconstructed in real-time and presented as a three-dimensional geometrical mapped color coded with the electrophysiological information. The CARTO represents an important tool to guide the ablation of patients who have focal tachycardia (e.g., right ventricular outflow tract [RVOT] tachycardia and idiopathic left ventricular [ILV] tachycardia). This study describes how the CARTO system is useful in mapping and ablating these arrhythmias. Two case illustrations, one patient with RVOT tachycardia and another with ILV tachycardia, are described in this article. The tachycardia was mapped and ablated using the new electromagnetic catheter technology creating an electroanatomical map of the arrhythmia focus for each tachycardia without fluoroscopy; both tachycardias were successfully ablated, terminated, and rendered noninducible. The CARTO system is useful in mapping and guiding the ablation of focal tachycardia and merits further study.