Non-invasive Mapping of Rhythm Disorders
Non-invasive Mapping of Rhythm Disorders
This current care protocol follows the biomedical research protocol entitled "Non-invasive
 mapping of the heart ECG high amplification" that demonstrated the clinical value of
 noninvasive Cardioinsight® mapping system.

 Guide the management of patients hospitalized for cardiac rhythm radiofrequency ablation of
 cardiac arrhythmias, implantation or programming of a pacemaker, or assess the risk of
 serious arrhythmias or sudden death, with the currently used non-invasive mapping routine.
 The results obtained with non-invasive mapping will be compared with those obtained with the
 conventional method without non-invasive mapping.
This current care protocol is for 3 groups of patients :

 1. Role of mapping arrhythmias before radiofrequency ablation :

 Radiofrequency ablation is a treatment of atrial or ventricular arrhythmias resistant to
 drug treatment. The electrocardiogram does not allow a full diagnosis of arrhythmias and
 it appears difficult to get a comprehensive and simultaneous view of cardiac activity
 during invasive maps. The Investigators have demonstrated the feasibility of mapping
 atrial fibrillation and its usefulness to guide radiofrequency ablation. The
 non-invasive mapping would allow a better understanding of complex cardiac arrhythmias
 mechanism (atrial fibrillation, ventricular tachycardia and ventricular fibrillation in
 particular), would identify the arrhythmogenic sites and thus facilitate radiofrequency
 ablation.

 2. Optimizing the site of implantation of cardiac pacing leads and programming the
 pacemaker:

 The optimal position of the cardiac pacing leads may vary from one patient to another
 and the current choice of implantation sites is essentially guided by imaging and does
 not use power requirements because of the inadequacies of the ECG standard. The
 Investigators have already demonstrated the usefulness of non-invasive mapping in the
 selection of potential responders to cardiac resynchronization therapy. The non-invasive
 mapping would study the cardiac electrical activation in order to determine the optimal
 pacing sites and optimum programming according to each patient and thus improve the
 clinical response to pacing.

 3. Role diagnostic and prognostic for patients referred for evaluation of the risk of
 occurrence of a serious rhythm disorder or sudden death :

 The possibility to identify electrically abnormal areas either during the activation, or
 during cardiac repolarization with the high-resolution ECG is an indication of myocardial
 pathology that can be both unapparent on standard ECG and inaccessible to imaging techniques
 (ultrasound, CT or MRI). It is likely that such electrical anomalies are early diagnostic
 features of heart disease that will later be apparent. Such anomalies can also have an
 adverse prognostic weight (risk of arrhythmias or sudden death) that can be corrected if it
 is highlighted. Non-invasive mapping seems particularly important in patients with
 unexplained symptoms by conventional tests (palpitations or discomfort - syncope). It will
 also be applicable to patients with heart disease (myocardial infarction, cardiomyopathy) in
 search of localized electrical disorders that can be an originating site of arrhythmia.
Inclusion Criteria:

 -  Oral agreement of the patient or of the holder of parental responsibility after
 reading the informed consent form.

 -  Patients with the following 3 conditions :

 -  Ablation of drugs rebels arrhythmias.

 -  Or implantation or programming of a pacemaker (pacemaker or defibrillator)

 -  Or symptoms and / or cardiopathy with risk of sudden death.

 Exclusion Criteria:

 -  Pregnancy and lactation.

 -  Patients unable to give oral agreement.

 -  Inconsistent patient's morphology with the establishment of the electrode jacket