Electro-anatomical four-dimensional mapping of ventricular tachycardia

The objectives of this study were: 1) to reconstruct the ventricular 3-D geometry by processing intracardiac echo (ICE) images, 2) to reconstruct the nesting position and orientation of the mapping catheters inside the ventricle, 3) integrate the geometrical information with the cardiac activity data recorded with the catheter and 4) to provide anatomic localization of electrical events during clinical ventricular tachycardia (VT). We employed commercially available 64-electrode mapping catheters, ICE equipment, a custom designed EP recording system and custom reconstruction software. In vitro, the positions of basket catheter electrodes were identified correctly. During clinical use, the basket electrode positions were not identified reliably by ICE. However, the nesting position of the basket was identified correctly. The custom software integrated the geometrical information and cardiac activity data off line, during the procedure. Electrical events occurring during VT were correctly displayed on the reconstructed geometry.