Biomagnetically localizable multipurpose catheter and method for MCG guided intracardiac electrophysiology, biopsy and ablation of cardiac arrhythmias

Abstract

A multipurpose catheter, specially designed to be biomagnetically localizable and the method for magnetocardiographic (MCG) guided intracardiac electrophysiological recordings, endomyocardial biopsy and ablation of cardiac arrhythmias are described. The catheter features two non-polarizable non-ferrous magnetic electrodes, arranged in such a way that, connected to an external current generator, an electromagnetic field of dipolar configuration can be generated in the heart. The connection is done with twisted pairs of non-ferrous magnetic conductors, to avoid the occurrence of spurious magnetic fields along the catheter during current injection to the electrodes. With this assembly the tip of the catheter can be localized (and driven close to an arrhythmogenic area) by MCG mapping. The same electrodes are feasible for monophasic action potential (MAP) recordings. One or more lumen allow fluid infusion, blood sampling, pressure measurements and introduction of steerable wires, pacing or ablation electrodes, bioptic devices, or optic fibers. On the basis of preoperative MCG three-dimensional localization of the arrhythmogenic substrate, the biomagnetically localizable catheter is driven, under fluoroscopic control, as close as possible to the suspected arrhythmogenic zone. MCG mapping is then performed under pacing, with adjustments of the catheter's tip, until the electrically induced magnetic field and catheter's localization parameters fit those generated by the spontaneous arrhythmia. MAP is recorded. The catheter position is accepted for ablation when electrophysiological abnormalities are identified in the MCG localized area.