Non-fluoroscopic mapping as a guide for atrial ablation: Current status and expectations for the future

Non-fluoroscopic, electroanatomic mapping technologies enable the display of the cardiac chambers and the relative position of ablation lesions. These three-dimensional (3D) systems are used to ablate various types of arrhythmia. The past decade has witnessed the development of an increasing number of AF ablation procedures largely based on anatomic considerations which prompted the explosive development of computer-based mapping for increasing accuracy. At present, 3D mapping and navigation technologies play a central role in the ablation of AF particularly in patients with long-lasting or permanent AF, regardless of whether pulmonary vein isolation or substrate modification is planned. Although no present mapping and navigation system may be considered ideal, their special features are discussed here. The purpose of this article is to review the current status and the clinical role of the available non-fluoroscopic mapping systems as well as expectations for the future.