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BioMed Research International
Volume 2016, Article ID 5340574, 13 pages
http://dx.doi.org/10.1155/2016/5340574
Research Article

Basket-Type Catheters: Diagnostic Pitfalls Caused by Deformation and Limited Coverage

1Institute of Biomedical Engineering, Karlsruhe Institute of Technology (KIT), 76131 Karlsruhe, Germany
2Institute for Experimental Cardiovascular Medicine, University Heart Center Freiburg ·​ Bad Krozingen, Medical Center, University of Freiburg, 79106 Freiburg, Germany
3Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
4Städtisches Klinikum Karlsruhe, 76133 Karlsruhe, Germany

Received 28 July 2016; Accepted 27 October 2016

Academic Editor: Flavia Ravelli

Copyright © 2016 Tobias Oesterlein et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Whole-chamber mapping using a 64-pole basket catheter (BC) has become a featured approach for the analysis of excitation patterns during atrial fibrillation. A flexible catheter design avoids perforation but may lead to spline bunching and influence coverage. We aim to quantify the catheter deformation and endocardial coverage in clinical situations and study the effect of catheter size and electrode arrangement using an in silico basket model. Atrial coverage and spline separation were evaluated quantitatively in an ensemble of clinical measurements. A computational model of the BC was implemented including an algorithm to adapt its shape to the atrial anatomy. Two clinically relevant mapping positions in each atrium were assessed in both clinical and simulated data. The simulation environment allowed varying both BC size and electrode arrangement. Results showed that interspline distances of more than 20 mm are common, leading to a coverage of less than 50% of the left atrial (LA) surface. In an ideal in silico scenario with variable catheter designs, a maximum coverage of 65% could be reached. As spline bunching and insufficient coverage can hardly be avoided, this has to be taken into account for interpretation of excitation patterns and development of new panoramic mapping techniques.