Abstract

In the last three decades the Cardiac Rhythmology field has experienced tremendous change and evolution. Our understanding of the underlying mechanism of arrhythmic diseases has dramatically improved, starting from the genetic and molecular mechanisms. Innovative pharmacological and non-pharmacological treatment options have been introduced, and arrhythmias previously considered “untreatable” are now successfully managed in most referral centers. The increasing awareness of the detrimental effects of arrhythmias on any underlying cardiac substrate, targeted as a potentially modifiable cause, has therefore led to an increasingly stronger effort in developing novel methods and approaches to treat arrhythmia and improve patients' health and quality of life. Of all potentially significant developments in the field, we have decided to focus on the approaches generally applicable to multiple arrhythmic cardiac disorders and related to the advancement of technology. More specifically, we will deal with electroanatomical mapping and lesion creation during interventional procedures.

Highlights

  • Division of Cardiology, Department of Medical Sciences, “Città Della Salute e Della Scienza di Torino” Hospital, University of Turin, Turin, Italy

  • Specialty section: This article was submitted to Cardiac Rhythmology, a section of the journal Frontiers in Cardiovascular Medicine

  • The cost associated with installing expensive Cardiovascular magnetic resonance (CMR) suites limits widespread application of this technology, the approach may prove to be cost-effective if associated to a significant improvement in patient outcome

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Summary

Matteo Anselmino and Gaetano Maria De Ferrari*

Three-dimensional (3D) electroanatomical mapping systems permit visualization of the catheters and of the created lesions in non-fluoroscopic virtual views, allowing near-zero radiation procedures [3,4,5] which may become the gold-standard for many approaches. These systems, originally designed to offer precise electrical activation and voltage data, have improved substrate recognition, significantly advancing treatment of complex arrhythmias. The three most widely used mapping systems (EnSite NavX by Abbott; Carto by Biosense Webster; and Rhythmia by Boston Scientific) will continue to improve and will be accompanied by new options with the potential to further implement cardiac substrate analysis, without exposure to harmful radiations

Cardiovascular Magnetic Resonance
New Electroanatomical Mapping Systems
Bipolar Radiofrequency Ablation
Stereotactic Radioablation
Findings
FINAL THOUGHTS
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