Novel catheter guidance technique to the site of origin of the arrhythmia

Abstract

The purpose of this study was to evaluate the accuracy of our catheter guidance system using Single Equivalent Moving Dipole (SEMD) method to guide the tip of the cardiac ablation catheter to the site of origin of the arrhythmia. 3 different patterns of 8 bipolar electrodes were sutured on the right ventricular myocardium of 3 swine through a standard thoracotomy. Electrode cables passed subcutaneously to a ventral interscapular position were exteriorized, fixed by stay sutures, and the chest closed in layers. The animals' heart rate, pulse oximetry, femoral artery blood pressure, and body temperature were continuously monitored. As the epicardial electrodes connected to a stimulator delivered pacing spikes simulating focal ventricular tachycardia at a rate of 120 bpm, the BioSemi ActiveTwo system at a frequency of 1Khz with a symmetrically patterned array of 64 electrodes placed on the chest measured body surface potentials. A paralytic drug was used to reduce error in cardiac mapping by minimizing muscular activity and allowing for full respirator control of breathing. Both simulation and real catheter's movements were well detected (R=0.95) and the final localization error of a simulation catheter to a pre‐defined target was less than 1 cm in imaginary space, which is equal to 0.4 cm in real space. These data support the validity of SEMD method for localizing the origin of arrhythmia in swine model.