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.