ELECTROPHYSIOLOGICAL SENSING, FOR MAPPING, PACING AND ABLATING

摘要

Accurate mapping of electrophysiologic activation within the human heart is achieved for discrete areas within the heart by utilizing a catheter having at least one pair of orthogonal sensors disposed on the catheter. Orthogonal sensors, which are comprised of two or more electrodes generally disposed circumferentially on the catheter at given longitudinal position along the catheter, receive signals which are differenced within a differential amplifier to produce a signal indicative only of the localized or near field biopotential heart activity. The orthogonal sensors are disposed adjacent to the stimulating tip of the catheter to allow sensing of the localized cardiac activity which is adjacent to or in contact with the stimulating tip during pacing procedures or during the delivery of radio frequency energy during ablation. Sensing of the localized cardiac activity occurs simultaneously either with the pacing or the ablation so that detailed and accurate electrocardiograms of the stimulated or ablated tissue region can be recorded. A plurality of such a orthogonal sensors longitudinally disposed along the body of the catheter with spacings between each of them of 1-3 millimeters allows for simultaneous mapping of localized cardiac activation at a corresponding plurality of positions within the heart wall even when physical contact between the sensing electrodes and heart wall does not or cannot occur.