Non-Contact Mapping and Ablation for Arrhythmias

Great Strides in the Treatment of Palpitations and Arrhythmias

By Leon A. Feldman, MD, FACC
Co-director, Cardiac Arrhythmia Program Eisenhower Smilow Heart Center

Everyone experiences the occasional palpitation or "skipped" heart beat. Occasionally, a cardiac rhythm disturbance can become a true nuisance or even indicate a serious problem with the heart. Over the past 10 years, advanced diagnosis and treatment of such problems has been available at the Cardiac Arrhythmia Program at the Eisenhower Smilow Heart Center, with the Coachella Valley's only full-service electrophysiology laboratories (EP labs).

Under the direction of board certified specialists in cardiac arrhythmia, Eisenhower Medical Center's EP labs have a specialized staff of caring nurses and technicians and a wide range of equipment and techniques. Services include pacemaker and defibrillator implantation, biventricular heart failure therapy, arrhythmia mapping and ablation (minimally invasive arrhythmia surgery). More than $1.5 million have been invested to ensure Eisenhower stays at the cutting edge of innovation. One exciting new addition is the EnSite 3000® Non-Contact Mapping System. This cutting edge technology helps identify and cure heart rhythm disorders.

This new equipment for treating complex heart rhythm problems supplements traditional procedures, which are often less precise, less effective and more time consuming. Previously, doctors would move several catheters around the heart chamber until they found the abnormal tissue that created a heart rhythm problem. Now, under local anesthetic, a small basket catheter is threaded though a vein into the heart. This catheter acts like a miniature radio antenna, receiving signals from all around the heart chamber and relaying them to a series of small, powerful computers. This specialized electrode is small and allows the heart to continue to pump normally. A detailed, three-dimensional map highlights areas of abnormal electrical activity. Even small movies, showing the speed and direction of arrhythmia as it travels throughout the heart, can be produced. More than 3,000 signals within the heart can be analyzed simultaneously, creating a colorful, anatomically accurate map. This wonderfully powerful tool enhances our ability to treat both simple palpitations and complex, life-threatening rhythm disturbances.

Once an abnormal electrical circuit is clearly diagnosed, a second catheter can be threaded into the heart chamber to cauterize or ablate the affected area. The EnSite 3000 system provides real-time images of an ablation in progress, allowing a level of precision not previously available. Following the ablation, the heart chamber can be quickly reexamined to confirm the success of the procedure.

This procedure is done under a local anesthetic, conferring low risk. It is minimally invasive, and can be offered to a wide range of patients, including adolescents and the very elderly. Patients may be discharged the same day or early the next morning. Only a small bandage is usually needed at the catheter insertion site, and normal activity resumes the following day. After a successful ablation, many patients reduce or even discontinue long-term medications that had been required to quiet the arrhythmia in the past.

In the United States, more than four million Americans experience cardiac rhythm disorders. Our electrophysiologists, using advanced technology, can now even more effectively deal with these complex diseases.

The EnSite 3000® system is only one of the state-of-the-art techniques available at the Cardiac Arrhythmia Program at the Eisenhower Smilow Heart Center.

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