![]() Illustration of catheter position detection by CARTO 3 system. Therefore, three of six body patches (back patches) are used along with the locator pad for the location reference as part of the Body Coordinate System. The accuracy of the catheter position must be maintained despite the artifacts caused by respiration, patient movement, cardiac activity, and system movement. This supports precise catheter navigation in the heart chamber. The illustrated catheter tip on the display screen presents these 6 degrees of freedom with an additional 4-color-information indicating the current position, rotation and deflection of the catheter and its movement in real time. In addition to this information, three orientation determinants are detected by the system: yaw, roll and pitch ( Figure 1B). For each coordinate, a current ratio is created by measurement of the current strength at each patch and stored by the system for adjustment with the magnetic-based data. Each electrode emits current at their own unique frequency. This calculation adjusts the current-based information generated by the system by sending a small current across a catheter electrode which is then registered via the six body patches and become evaluated. This allows calculation of the distance from catheter tip to each of the three electromagnets ( Figure 1A). The metal tip of the catheter moves through these fields and generates an electrical current depending on the strength of the magnetic field and orientation of the catheter tip in it. Three different electromagnets generate three low-intensity magnetic fields. The magnetic field emitter under the catheter table serves this purpose. The CARTO system generates a real-time map by processing the local electrograms and spatial information at the catheter tip, while the catheter is precisely localized by using a triangulation algorithm similar to the principle function of GPS technology. The nonfluoroscopic CARTO system uses hybrid magnetic and current-based measurement to allow precise catheter location inside the heart with an accuracy of less than 1 mm. The system consists of a locator pad with three separate low-level magnetic field emitting coils (5x10-6 to 5x10-5 tesla) being arranged as a triangle under the patient, 6 body patches, a mapping catheter with embedded magnetic location sensors in its tip, a data processing unit and a graphic display unit to provide visualization of the electroanatomical model being created. We present a modern workflow, that unites three-dimensional LA mapping with collecting relevant local information, image integration for refining the map and beneficial use of contact force based ablation approach.ĬARTO 3 is the third-generation electroanatomical mapping system from Biosense Webster and is currently available with the latest software version 6. ![]() In this review article, we aim to emphasize the most important aspects of possibilities that make both systems so valuable for interventional treatment of atrial fibrillation. Paul, Min) differ in construction and principles of the underlying mapping technology. The commonly used three-dimensional mapping systems CARTO 3 (Biosense Webster, Irvine, Ca.) and Ensite Precision (St. Increased precision of catheter localization by modern three-dimensional mapping systems, faster and better processing of local electrograms and their immediate color-based visualization make it possible to treat even challenging arrhythmias very effectively. Pulmonary vein isolation is thereby the cornerstone in this interventional treatment. Catheter ablation of atrial fibrillation has evolved enormously thanks to rapid improvement of modern mapping technologies, progress in catheter development and current possibilities for reduction of radiation exposure.
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