ABSTRACT 82

THE NOVEL NON-FLUOROSCOPIC THREE DIMENSIONAL ELECTROANOTOMICAL MAPPING SYSTEM AS IMAGING MODALITY FOR THE OPERATING ROOM OF THE FUTURE

Gil Bolotin, Frederik van der Veen, Tamir Owlf,  Robert Shachner, Uyval Sezbon, Daniel Reisfeld, Rona Shoftin, Roberto Lorusso, Shlomo Ben-Haim, Gideon Uretzky

Background.  The new method of three-dimensional electroanatomical mapping has been presented as an important tool for cardiac imaging and intervention.  We present herein the first use of this technology for the monitoring and imaging of cardiac surgery.

Methods.  Utilizing a locatable catheter connected to an endocardial mapping and navigating system, the system accurately establishes the location and orientation of the tip of the mapping catheter and simultaneously records its local electrogram.  The three-dimensional geometry of the beating cardiac chamber is reconstructed in real time.  The system was tested on six goats that underwent dynamic cardiomyoplasty.

Results.  The electranatomical mapping system provided an accurate three-dimensional reconstruction of the beating left ventricle during the operation.  Left ventricular end-diastolic volume reduction was documented in the maps obtained after the wrapping procedure, as compared to the  pre-operation baseline map (60.9 12ml vs 80.6  11 ml, p< 0.05),  An examination of three different areas using cross sections of the apex, mid and base of the heart revealed significant end-diastolic area reduction in the base and mid parts of the heart (948 194 mm² vs 1245  33 mm², p= 0.021 and 779  200 mm² vs 1011  80 mm² p= 0.016).  The area in the cross section f the apex did not change during the operation.

Conclusions.  The three dimensional electroanatomic mapping system allows detailed reconstruction of the left ventricular geometry and a clear view of changes that occur during cardiac surgery.  This novel monitoring system may serve as an important tool for imaging and analysis in future cardiac surgery.