Electroanatomic voltage mapping for tissue characterization beyond arrhythmia definition: A systematic review.

Area of Science:

• Cardiovascular Electrophysiology
• Medical Imaging
• Cardiac Anatomy

Background:

• Electroanatomic mapping (EAM) systems create 3D reconstructions for understanding arrhythmia mechanisms using dynamic and static maps.
• While primarily used for arrhythmia circuit identification, EAM systems possess untapped potential for broader clinical applications.

Purpose of the Study:

• To review current literature on the utilization of 3D electroanatomic mapping systems beyond their conventional role in arrhythmia definition.
• To highlight the emerging and established applications of EAM in tissue characterization and diagnostics.

Main Methods:

• Systematic literature review of studies investigating 3D EAM systems.
• Analysis of data on EAM applications in myocardial viability, scar detection, and specific cardiac conditions.

Main Results:

• Established data support EAM for electromechanical myocardial viability and scar detection in various cardiomyopathies.
• Emerging evidence demonstrates EAM's utility in Brugada syndrome and cardiac resynchronization therapy (CRT) procedures.
• EAM is not yet widely adopted as a standalone diagnostic tool despite its comprehensive data acquisition capabilities.

Conclusions:

• 3D EAM systems provide significant anatomical and functional information for tissue characterization, extending beyond arrhythmia analysis.
• Further integration of EAM into diagnostic pathways could enhance patient management for a range of cardiac conditions.
• Continued research is warranted to fully leverage EAM's capabilities in diverse clinical settings.