Applicability of trans-septal catheterisation and left ventricular electromechanical mapping for detection of myocardial viability

Aim. NOGA is a 3-dimensional (3D) left ventricular (LV) mapping system that uses special magnetically locatable catheters connected to a mapping and navigation system for detection of myocardial viability. We evaluated the applicability of venous, trans-septal catherisation and electromechanical mapping of the LV in patients with ischaemic heart disease. Methods. A 3D electromechanical map of the LV was created by sampling the catheter tip position throughout the cardiac cycle at a plurality of endocardial sites together with their local unipolar electrograms. Number of points for three-dimensional maps before and after post-processing editing, scatters of points in each region of a nine segment model of the LV and time needed to construct the maps were measured in 12 patients (mean+SD age 59+12 yrs) with stable angina and impaired LV function ( EF 32+10%). Results. Number of points achieved for three-dimensional maps were 82+16 before and 54+13 after editing. Time required to construct the maps were 43±13 minutes. Points were equally distributed throughout the nine segments for all patients. No complications were registered. Conclusion. The new trans-septal access for LV NOGA mapping is safe and easy and provides electromechanical LV mapping of excellent quality.