Future of cardiac mapping

Mapping remains a field in which knowledge of “where” remains as important as “how.” Integration of the various facets of cardiac imaging with real-time feedback to traditional principles of arrhythmia mapping will help to increase the efficiency of current clinical practice. Cardiac arrhythmias course the terrain of the human heart with a sense of direction guided by potential difference and resistances. This chapter provides a brief list of the currently available modalities for creating cardiac maps, with their advantages and disadvantages. Recently, functional imaging coupled with electroanatomical mapping (EAM) or anatomical imaging has gained importance. Most arrhythmias, with perhaps the exception of atrioventricular nodal reentrant tachycardia (AVNRT), rely on precise mapping techniques to elicit the sites of pathology contributing to the arrhythmia. Optical imaging provides an excellent way to view the myocardium in real time in order to assess ablation lesions, provide mapping guidance of cardiac chambers, and review local tissue characteristics.