3D Mapping

Medically Reviewed By William C. Lloyd III, MD, FACS
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What is 3D mapping of the heart?

3D mapping creates a multidimensional image of the heart’s anatomy. During cardiac mapping, your doctor stimulates the heart muscle to watch it beat and identify abnormalities related to a faulty heart rhythm (cardiac arrhythmia). Cardiac mapping is an electrophysiology (EP) procedure, which means it traces the electrical impulses generated by the cells of your heart.

Why is 3D mapping performed?

Your doctor may recommend 3D mapping to diagnose the source of an arrhythmia like atrial fibrillation (afib). Normally the heart’s “pacemaker” cells send out a synchronized cascade of electrical impulses that cause the heart to contract (beat) in a rhythmic fashion. When this system becomes faulty, the heart can start to beat too fast, too slow, or in an erratic manner.

Arrhythmia mapping can help your doctor identify specific areas that are not beating correctly. 3D mapping images can show heart tissue that may not be receiving electrical impulses in the correct sequence or areas that are sending inappropriate signals to contract prematurely. Your doctor uses the electrical map of your heart to plan the most appropriate treatment, such as cardiac ablation. Doctors may perform cardiac mapping and ablation during the same procedure appointment. Your doctor may also recommend other cardiac diagnostic and imaging procedures.

Sometimes 3D mapping is used to identify structural heart abnormalities or to try to determine the cause of sudden fainting episodes.

Who performs 3D mapping?

Cardiologists with additional expertise in interventional cardiology or cardiac electrophysiology perform 3D mapping. An interventional cardiologist specializes in minimally invasive procedures that diagnose or treat common heart ailments like afib and blocked coronary arteries. A cardiac electrophysiologist specializes in diagnosing and treating abnormal heart rhythms.

When choosing one of these specialists to perform the procedure, look for a doctor who is board certified in the specialty they practice and has a great deal of expertise and success with arrhythmia mapping. Board certification means the doctor has undergone specialized training and passed a rigorous examination.

How is 3D mapping performed?

3D mapping of the heart is performed in either a cardiac catheterization (cath) laboratory or a specialized EP lab. These labs are in hospitals, medical centers, and sometimes in outpatient facilities. 3D mapping is a minimally invasive procedure. Your doctor inserts a specialized cardiac mapping catheter (a very thin, flexible tube with sensors at the tip) through an artery in your groin or arm and then advances the catheter into the heart. The cardiac mapping system tracks the catheter’s location as your doctor moves it to different areas throughout your heart. The system uses the information to create an electrical map of your heart.

You will receive medications to help you feel relaxed and comfortable throughout the procedure. A specialized team of cardiologists, anesthesiologists, nurses and technicians will oversee your care.

As a minimally invasive procedure, cardiac mapping carries fewer risks than open heart surgery. In general, you will be able to return home the same day and should experience only minor discomfort.

What to expect the day of your 3D mapping procedure

After checking in at the facility, your day will typically follow this series of events:

  • A preoperative nurse will speak with you and make sure you understand the procedure and complete any necessary forms.

  • You will change into a hospital gown and receive an intravenous (IV) line with fluids.

  • You will be escorted or transported to the cath lab or EP lab, where you will lie face-up on a table.

  • The person in charge of your anesthesia will ask you about your medical history and discuss the sedative and local anesthetic you will have.

  • The anesthetist will administer mild sedatives through the IV to relax you.

  • The cardiologist will administer the anesthetic at the incision site in your groin or arm and make a small incision.

  • The cardiologist will insert the catheter and guide it into your heart.

  • You may feel mild pressure in the groin or arm or strange sensations like fluttering in your chest during the mapping procedure.

  • You will be moved to a recovery room with specially trained nurses. Here, you’ll need to lie still and flat on your back for an extended period of time.

  • You will be discharged home with specific post-procedure care instructions.

What are the risks and potential complications of 3D mapping?

While a minimally invasive procedure like 3D mapping tends to carry fewer risks than a traditional, open surgery, there are specific risks related to EP studies. You should always discuss the risks and benefits of any procedure with your doctor before proceeding.

General risks of minimally invasive surgery and catheter-based procedures

The general risks of minimally invasive surgery include:

Potential complications of 3D mapping

Most heart mapping procedures proceed without problems, but potential complications include:  

  • Bleeding, bruising, or blood clot

  • Heart arrhythmia during or after the procedure

  • Accidental perforation of a blood vessel or the heart muscle, which can cause blood loss or a heart attack

  • Nerve damage leading to loss of sensation in the leg or arm

  • Pseudoaneurysm (damage to the large artery used for catheter access)

Reducing your risk of complications

You can reduce your risk of certain complications by:

  • Following your care team’s activity, dietary and lifestyle restrictions and recommendations before your procedure and during recovery

  • Notifying your doctor immediately of any concerns, such as bleeding, fever, or increase in pain

  • Taking your medications exactly as directed

  • Telling all members of your care team if you have allergies or if you’ve ever had a reaction to an anesthetic

How do I prepare for 3D cardiac mapping?

You can prepare for by:

  • Stopping all food and drink at the time specified by your doctor

  • Following the medication protocol from your doctor. If you take daily medications, your doctor may want you to stop some of them or continue taking them on the day of your procedure. Be sure you understand which prescriptions to take and which to temporarily discontinue.

Questions to ask your doctor

If your doctor recommends you undergo cardiac mapping, you may want to ask:

  • What is the purpose of this procedure? Will you perform cardiac ablation treatment at the time of the mapping procedure?

  • What are the risks involved?

  • What can I do to reduce my risk for complications?

  • How will you treat and manage complications?

  • What is your plan for pain management during and after the procedure?

  • Will I be able to drive myself to and from the appointment?

  • What activity and/or diet restrictions should I plan for after I go home?

  • What should I do, or who should I call, if I experience bleeding, fever or pain after I have gone home?

What can I expect after my 3D mapping procedure?

One of the most important things you can do after the procedure is to carefully follow your doctor’s activity restrictions. The incision site in your groin or arm needs time to fully heal, and you should avoid any activities that could cause it to open and bleed. If you do experience bleeding from the incision, you should apply firm pressure immediately for at least five minutes and call your doctor’s office.

How long will it take to recover?

You probably will be able to go home the same day of your procedure. You should rest, drink plenty of fluids, and eat a regular diet. Within a few days, you should be able to resume normal activities, following your doctor’s instructions.

Will I feel pain?

You may feel some mild discomfort at the catheter incision site. Your doctor will explain how to manage this mild pain after you go home. You may also feel some muscle stiffness from lying on your back for an extended period of time during and after the procedure. This discomfort should resolve quickly—within hours or a couple of days.

When should I call my doctor?

Most people recover from the 3D mapping procedure without complications, but you should call your doctor right away or seek immediate medical care if you have:

How might a 3D mapping procedure affect my everyday life?

If the heart map identifies the cause of your heart arrhythmia, your doctor may be able to correct the problem and restore your heart’s normal beating pattern. Arrhythmia treatments include cardiac ablation, maze procedure, cardioversion, implantable devices, and medications. This can result in increased energy as oxygen-rich blood is more effectively pumped to your body again. Your doctor may perform some of these treatments at the time of your mapping procedure.

In the short term, you will need to limit your physical activity after a 3D mapping procedure to ensure the incision site heals well. However, you likely will not experience any long-term limitations after undergoing this electrophysiology study.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Aug 21
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. 3D electrical mapping of the heart. MedMovie. https://medmovie.com/library_id/7556/topic/cvml_0307a/
  2. Electroanatomic Mapping Systems for Ablation. StopAfib.org http://www.stopafib.org/catheter-ablation/technology-electroanatomic.cfm
  3. How are arrhythmias diagnosed? National Heart, Lung and Blood Institute. https://www.nhlbi.nih.gov/health/health-topics/topics/arr/diagnosis
  4. What are electrophysiologic tests? American Heart Association. http://www.heart.org/idc/groups/heart-public/@wcm/@hcm/documents/downloadable/ucm_300439.pdf