What is 3D Ablation and Mapping?

What is 3D Ablation?

3D ablation and mapping shows the three-dimensional shape of your heart, its vitality and the propagation of electrical signals. The origin and mechanism of the palpitations are identified and a burning procedure called ablation is performed to terminate them.

Various patches are placed on the patient’s chest and back, and a device that creates a magnetic field is placed under the angiography table in the area of the patient’s back. These patches contain sensors that detect the magnetic signal at the tip of the catheter and reflect the position of the catheter. As the catheter is moved through the heart cavity, thousands of signals are collected. Both anatomy and electrical activity are assessed. Sick and healthy tissues are identified. How electrical activity propagates is assessed. The palpitation mechanism or target tissues that cause palpitations are identified. Burning is used to prevent rhythm disturbances from arising from these areas.

In this video you see how 3D mapping is realized.

In Which Arrhythmias Is 3D Ablation Performed?

3D Ablation can theoretically be performed in all arrhythmias. With 3D mapping, the anatomy of the heart can be removed and the area where the arrhythmia originates can be seen and burned. In some arrhythmias, it is necessary to ablate very small, limited areas. In such cases, ablation can be performed without mapping, just by looking at the signals.

In arrhythmias such as ventricular tachycardia, atrial flutter or fibrillation, atrial tachycardia, atrial extrasystole and ventricular extrasystole, 3D mapping is usually required to fully characterize the mechanism of the problem.

Does the patient feel pain during mapping?

The patient does not feel pain during mapping. A catheter is inserted into your heart chambers and the boundaries of that chamber are determined. In addition, by looking at the voltage of the walls, it is also understood whether there is dead tissue.

Does the Patient Receive Radiation in 3D Mapping?

In 3D mapping, you do not receive radiation. Various sensors are attached to your chest and a magnetic field generating device is placed under the angiography table at chest level. These sensors detect the position of the catheters (3-4 mm thick cables) that are passed through the heart and mapping is performed.

What is done after mapping?

After the map is created, depending on the type of palpitations, the electrical signals are evaluated and the place or places where the palpitations originate are mapped and found point by point. Ablation is then applied to these places. In some rhythm disorders, such as atrial fibrillation (AFib), there are localized areas where the palpitations originate. Ablation is applied to these areas. See the related content for AFib ablation here.

3D ablation of PVCs
3D ablation of PVCs. The white dot shows the site of the rhythm disorders.
WPW 3D ablation
WPW 3D ablation - the white dot shows the area of the accessory pathway.

Update: Feb 13, 2024

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Picture of Prof. Dr. Taylan Akgün
Prof. Dr. Taylan Akgün

He is a cardiologist specialised in the diagnosis and treatment of heart rhythm problems (ablation), pacemaker procedures.
He works in Istanbul province.

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