Precision Mapping Provides Foundation for Successful Ablations at Cooper

The refinement of electro-anatomic mapping technology has led to significant growth in the use of ablation therapy for patients with persistent arrhythmias. These advances are welcomed by electrophysiologists at the Cooper Heart Institute.

“Electroanatomic mapping has revolutionized ablation therapy,” says Lawrence Gessman, M.D., director of the Cooper electrophysiology laboratory. “Conventional mapping is a tedious, time-consuming procedure that limits the clinician’s flexibility to identify multiple sites or rapidly find the optimal site to the nearest millimeter. In addition, it can extend the fluoroscopy time to an undesirable level for the patient and the staff.”

Arrhythmia Mapping

Electroanatomic or CARTO mapping technology is derived from the principle that metal coils in the ablation catheter tip will produce an electronic current when positioned in a magnetic field. “The system employs the low-dose magnetic field emitter with the location sensor in the ablation catheter tip,” says Dr. Gessman. “ The combination of emitter and sensor generates a precise graphic in 3-dimension, identifying the location of the catheter tip in space.”

Mapping utilizes a triangulation algorithm not unlike global positioning systems. The catheter is initially placed at known anatomic landmarks. Then the catheter, which is visualized on a screen, is advanced along the chamber walls to map the chamber and arrhythmia locations. The advanced technology provides color-coded, real-time images, that can be rotated in any direction with single or multiple views. This manipulation allows for comparison and study of specific areas, as well as potential ablation targets.

The Cooper Heart Institute is the only South Jersey institution to offer electroanatomic mapping via the Biosense Webster CARTO Navigation Mapping System. “This technology is equipped with software that allows for enhanced viewing and a greater degree of accuracy in ablating arrhythmia foci,” says Dr. Gessman. “The enhancement is a tremendous benefit in the new techniques being performed at Cooper for atrial fibrillation ablation, atrial flutter ablation, and certain ventricular arrhythmias such as supraventricular tachycardia (SVT), and ventricular tachycardia (VT).”

Ablating Atrial Flutter

Atrial flutter is less common than atrial fibrillation, however, more than 100,000 new cases are reported each year. Usually secondary to underlying cardiac or respiratory disease, patients may present with both flutter and fibrillation.

“Atrial flutter ablation is generally responsive and less technically difficult than ablating atrial fibrillation,” says Dr. Gessman. “However, it is rarely offered as a first-line therapy.” says Dr. Gessman. “We routinely try patients on a regime of anti-arrhythmics before we consider ablation therapy. Age and concurrent medical therapy is often a deciding factor.”

“With advances in mapping technology we are often able to offer arrhythmia patients curative treatment rather than simply management of their symptoms,” says Dr. Gessman.

To contact Dr. Gessman, please call (856) 342-2034.