Atrial electro-anatomic mapping with a novel noncontact approach

Multi-electrode basket catheters are used for 3D mapping of complex focal arrhythmias in real-time, but full contact is hard to achieve for all electrodes in the atria. We have developed a novel inverse mapping approach, which enables endocardial potentials to be recovered from noncontact recordings and report on its efficacy. Intra-atrial electrograms were acquired with 64 channel Constellation™ catheters in 4 anesthetized sheep in sinus rhythm (SR), atrial pacing (AP) and atrial fibrillation (AF), with catheters of different dimension at various locations in right and/or left atria (RA, LA). Atrial endocardial potentials were recovered from noncontact recordings using finite-element and meshless inverse methods. Inverse mapping reproduced contact electrograms, recorded separately at distributed sites, with excellent accuracy in SR and AP [CC 0.8+0.18, time delay 1+3 ms, relative RMS error 0.53+0.17, n=96]. Moreover, repeatable activation time maps were obtained in SR and AP. Focal activity was identified in AF and precise noncontact region-of-interest mapping was also demonstrated.