New high-density and automated mapping systems
Three-dimensional electroanatomical mapping (EAM) systems realistically made it feasible to map focal or reentrant arrhythmias from one of the cardiac chambers. The importance of optimized detailed and accurate mapping within the regions previously considered to be dense homogeneous scar was emphasized with an MRI-EAM correlation ventricular tachycardia study. Emerging software and hardware advances have enabled improved mapping of simple and complex arrhythmias. This chapter reviews the main features of commercially available EAM systems and how these systems enable ultra-high-density mapping. The Rhythmia mapping system was developed in order to provide high-resolution, high-density activation sequence mapping in a highly automated fashion based upon several advances in electrogram acquisition, annotation, and interelectrogram comparisons. A major advantage of the Rhythmia mapping system is its ability to record very small amplitude signals. There are several features that allow this ultrasensitive potential detection.