remarkable treatment for abnormal heart rhythms has been revolutionized with the introduction of a new "basket" catheter that allows physicians to simultaneously map 64 individual spots within the heart. Winthrop's electrophysiologists are among the first in the region to use this device. It represents a marked improvement over the standard catheter used to perform radiofrequency ablation, an invasive technique that short-circuits faulty electrical pathways responsible for many heart rhythm disturbances.
Todd Cohen, MD, demonstrates how the "basket" catheter expands to fill the heart's chamber. Sixty-four electrodes in the basket's wires help electrophysiologists locate the precise location where rhythm disturbances in the heart originate.
The human heart's normal, steady beat is triggered by an electrical impulse that occurs between 70 - 100 times per minute. Sometimes, however, extra pathways in the heart can result in arrhythmias, where the heart beats too slowly, too fast, or at an irregular pace. Severe arrhythmias can be life-threatening; even mild cases can place a strain on the heart that can lead to long-term damage.
Some arrhythmias can be managed with medication. For those that cannot, radiofrequency ablation - which involves threading a catheter into the heart - represents a cure. Electrodes at the tip of the catheter enable the electrophysiologist to "map" the heart chamber and locate the site where the rhythm disturbance originates. A separate catheter is used to deliver radiofrequency waves to that precise location, disrupting the pathway so that the abnormal conduction cannot take place.
This new basket catheter, called "Constellation," enlarges to fill the heart's chamber. It contains 64 electrodes along its eight individual wires to simultaneously map the chamber, providing much more information in a shorter period of time.
"Point-to-point mapping is a tedious technique where we touch one spot in the heart, move the catheter, and then touch another area," explains Todd Cohen, MD, Director of Electrophysiology at Winthrop and Director of the Winthrop Pacemaker and Arrhythmia Center. "The basket contours to the chamber of the heart and records information from a single heartbeat, so we are able to map the arrhythmia in much less time and with more accuracy."
The ability to map multiple points simultaneously overcomes a deficiency inherent in the single point catheter. "There are different types of short-circuits inside the heart, and they may originate in more than one location," Dr. Cohen notes.
The new technique promises to be especially useful for patients with atrial and ventricular tachycardias - episodes of very fast heartbeats that originate in the upper or lower chambers of the heart, respectively.
With the Constellation still in place, electrophysiologists can use the basket catheter's 64 electrodes to re-map the heart after ablation to immediately assess the treatment's success.
Dr. Cohen has extensive experience with radiofrequency catheter ablation of every type. In addition to his Winthrop position, he is Associate Professor of Medicine at SUNY-Stony Brook School of Medicine, with which Winthrop has a major academic affiliation. He is the author of more than 150 publications. For additional information on radiofrequency catheter ablation at Winthrop, call the Institute for Heart Care at 1-800-443-2788.