Method for guiding the ablation catheter to the ablation site: a simulation and experimental study

Radiofrequency catheter ablation (RCA) procedures for treating ventricular arrhythmias have evolved significantly over the past several years; however, the use of RCA has been limited due to the difficulty in identifying the appropriate site for ablation. In this study, we investigate the accuracy of a computer algorithm to guide the tip of an ablation catheter to the exit site of the scar tissue or the site of abnormal automaticity (the "target site"). This algorithm involves modeling the body surface potentials corresponding to the wavefront at the target site for ablation and current pulses generated from a pair of electrodes at the tip of the ablation catheter with a single equivalent moving dipole (SEMD) in an infinite homogeneous volume conductor. Despite the fact that the use of the homogeneous volume conductor introduces systematic error in the estimated compared to the true dipole location, we find that the systematic error had minor influence in the ability of the algorithm to accurately guide the tip of the ablation catheter to the ablation site and the overall error (1.9 +/- 1.1 mm) in the left ventricle is adequate for RCA procedures. These results were verified, in saline tank studies in which the distance between the dipole due to the catheter tip and the dipole due to the target site was found to be 2.66 +/- 0.52 mm. In conclusion, our algorithm to estimate the SEMD parameters from body surface potentials can potentially be a useful method to rapidly and accurately guide the catheter tip to the arrhythmic site during an RCA procedure.