Update on rhythm mapping and catheter navigation

Rhythm mapping in electrophysiology is a critical step in the catheter ablation of arrhythmia substrates. The past decade has seen major advances in the technology used by electrophysiologists to visualize and treat arrhythmias. This review will summarize the most recent developments in three-dimensional electroanatomic mapping and in catheter navigation.

Three-dimensional contact and noncontact mapping systems have a proven efficacy in multiple clinical studies. Advances in technology have led to the integration of imaging and mapping to produce an increasingly realistic representation of arrhythmias. These systems have been used both to improve success in the treatment of arrhythmias and to enhance our understanding of cardiac electroanatomy and electrophysiology. Additionally, remote catheter mapping technology, although not widely used in pediatrics, may be an important tool to decrease procedural risks to both the patient and physician.

Technological developments have occurred rapidly over the past several years. Three-dimensional electroanatomic mapping has proven to be a key tool for the success of complex arrhythmia ablations, especially in patients with congenital heart disease. The integration of imaging technology and arrhythmia mapping technology has greatly enhanced the understanding and visualization of arrhythmias. Remote catheter navigation may become an important tool to improve safety.