electroanatomic

Electroanatomic mapping is a set of techniques that integrate electrical activity data from intracardiac electrodes with three-dimensional anatomical models of the heart to create maps used in cardiac electrophysiology. These maps display activation times, voltage, and conduction properties across cardiac chambers, helping identify arrhythmia circuits and potential ablation targets.

Mapping systems often use catheters with sensors and include software to reconstruct geometry via magnetic or impedance tracking, generating activation, voltage, and substrate maps. The resulting information can be displayed as color-coded maps and is used to guide diagnostic assessment and therapeutic interventions, including pacing maneuvers and catheter ablation. In many cases, electroanatomic mapping can be performed with reduced or minimal fluoroscopy, improving safety for patients and operators.

Applications span a range of arrhythmias, including atrial fibrillation, atrial flutter, and ventricular tachycardia. For focal arrhythmias, mapping aims to localize the origin, while for reentrant arrhythmias it helps delineate critical channels and slow-conduction zones that serve as ablation targets. Substrate mapping, which looks at low-voltage areas and conduction properties, is used to identify zones that sustain arrhythmias, particularly in scar-related VT.

Limitations include dependence on stable catheter contact and patient movement, potential mapping artifacts, and the time required to collect comprehensive data. Operator experience and system choice influence accuracy and efficiency. Historically, electroanatomic mapping emerged in the late 1990s with early systems such as CARTO and EnSite and has since become a standard tool in many EP laboratories, often integrated with preoperative imaging modalities.