The present invention provides multi-functional medical catheters, systems and methods for their use. In one particular embodiment, a medical catheter (100) includes a flexible elongate body (105) having a proximal end (110) and a distal end (120). A plurality of spaced apart electrodes (130 136) are operably attached to the flexible body near the distal end. At least some of the electrodes are adapted for mapping a tissue and, in some embodiments, at least one of the electrodes is adapted for ablating a desired portion of the tissue. The catheter includes a plurality of tissue orientation detectors (140 146) disposed between at least some of the electrodes. In this manner, the medical catheter is capable of tissue mapping, tissue imaging, tissue orientation, and/or tissue treatment functions.