Download Catheter ablation of common atrial flutter using the LocaLisa system

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LocaLisa: Electrical Localization of Endocardial Electrodes.
F. H..M. Wittkampf, R Derksen, P. Loh, E.F.D. Wever, A.A.M. Wilde.
University Hospital, Utrecht, The Netherlands
Citation: European Heart Journal Vol 19: Abstr. Suppl. 1997, Page 205
Abstract 1208
Estimation of the three dimensional (3D) position of an ablation electrode from
biplane fluoroscopic images is inadequate if a systematic lesion pattern is
required for complex arrhythmogenic substrates. We studied the accuracy of a
new electrode localization technique (LocaLisa). Using an orthogonal lead
system, a low power high frequency current is delivered through the thorax,
using slightly different frequencies around 30 KHz for the three orthogonal
directions. The resulting high frequency signal, recorded from an endocardial
electrode, is selectively filtered for the three frequencies to obtain a unique
measure of the position of that electrode within the thorax. This method was
applied using 2 to 3 different positions of a decapolar catheter in the right or left
ventricle of 20 patients (10 RV, 10 LV). To determine the accuracy within one
ventricle, LocaLisa data obtained from 2 to 3 catheter (20-30 electrode) positions
per ventricle were analysed using calibrated biplane fluoroscopy as the golden
standard. For a particular cardiac segment, data from the 10 electrodes were
compared with the true inter-electrode distances for each catheter position.
The high frequency currents did not cause any noise on the unipolar or bipolar
electrograms. The mean spatial error of the calculated electrode positions within
one ventricle was 7mm for both ventricles partly due to inaccuracies of biplane
fluoroscopy. When, however, data obtained from 10 catheter electrodes were
compared with the true interelectrode distances, the relationship between known
and calculated interelectrode distances was extremely linear with a mean
correlation coefficient of 0.995 (RV) and 0.998 (LV). This compares to a mean
standard deviation of 1.6 and 1mm, respectively, in an area of 5-6cm in cross
The LocaLisa method is sufficiently accurate for non-fluoroscopic mapping and
ablation in a single chamber or segment thereof. It does not affect electrogram
recording, and can be applied to any electrode catheter.
LocaLisa Abstract 3