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Endoventricular Electromechanical Mapping—The Diagnostic and Therapeutic Utility of the NOGA® XP Cardiac Navigation System

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Abstract

Combined analysis of the electrical and mechanical function of the heart holds promise as a means of acquiring a better understanding of a variety of cardiac diseases that ultimately may lead to heart failure. The NOGA® XP Cardiac Navigation System is a unique, nonfluoroscopic, catheter-based technology that achieves real-time acquisition of three-dimensional, endoventricular electromechanical maps. Through the provision of point-by-point measurements of endocardial electrical activation and voltage and mechanical shortening, electromechanical mapping has been evaluated for its ability to identify regional myocardial ischemia and characterize tissue viability. A decade of preclinical and clinical research has verified its safety and feasibility and raised the possibility of its application as a diagnostic adjunct to conventional angiography in the catheterization laboratory. However, this role has not yet been realized outside of the research setting. Instead, a more prominent niche for NOGA® XP has emerged as a therapeutic tool for guiding direct myocardial interventions, most notably the targeted administration of regenerative therapies (e.g., cells, genes) to the heart. In this review, we discuss the fundamental aspects of this electromechanical mapping system and the evidence for both its diagnostic and therapeutic utility.

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Acknowledgments

The authors would like to thank Dr. Troy Jantzen (Biosense Webster, Johnson & Johnson Medical) and Mr. Jonathan Wong (Biologics Delivery Systems Group, Cordis Corporation) for their assistance during the writing of this manuscript, along with Dr. Emerson Perin and Mr. Fred Baimbridge (Texas Heart Institute, Houston, Texas) for kindly providing the images in Fig. 3. Dr. Psaltis and Professor Worthley have no financial conflicts to report. Dr. Psaltis is supported by post-graduate research scholarships from the National Health and Medical Research Council and National Heart Foundation of Australia and the Royal Adelaide Hospital.

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  1. Cardiovascular Research Centre, Royal Adelaide Hospital, Adelaide, South Australia, Australia

    Peter J. Psaltis & Stephen G. Worthley

  2. Department of Medicine, The University of Adelaide, Adelaide, South Australia, 5000, Australia

    Peter J. Psaltis & Stephen G. Worthley

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  1. Peter J. Psaltis
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  2. Stephen G. Worthley
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Correspondence to Stephen G. Worthley.

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Psaltis, P.J., Worthley, S.G. Endoventricular Electromechanical Mapping—The Diagnostic and Therapeutic Utility of the NOGA® XP Cardiac Navigation System. J. of Cardiovasc. Trans. Res. 2, 48–62 (2009). https://doi.org/10.1007/s12265-008-9080-7

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  • DOI: https://doi.org/10.1007/s12265-008-9080-7

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