Catheter based simultaneous mapping of cardiac activation and motion: a review

Heart failure as a result of a variety of cardiac diseases is an ever growing, challenging condition that demands profound insight in the electrical and mechanical state of the myocardium. Assessment of cardiac function has largely relied on evaluation of cardiac motion by multiple imaging techniques. In recent years electrical properties have gained attention as heart failure could be improved by biventricular resynchronization therapy. In contrast to early belief, QRS widening as a result of left bundle branch block could not be identified as a surrogate for asynchronous contraction. The combined analysis of electrical and mechanical function is yet a largely experimental approach. Several mapping system are principally capable for this analysis, the most prominent being the NOGA-XP system. Electromechanical maps have concentrated on the local shortening of the reconstructed endocardial surface from end-diastole to end-systole. Temporal analysis of motion propagation, however, is a new aspect. The fundamental principles of percutaneous catheter based activation and motion assessment are reviewed. Related experimental setups are presented and their main findings discussed.