From the Center for Experimental Cardiac Electrophysiology, Section of
Cardiology, Department of Medicine, Baylor College of Medicine, Houston, Tex.
Correspondence to Dirar S. Khoury, PhD, The Methodist Hospital, 6565 Fannin St, M941A, Houston, TX 77030. E-mail dkhoury{at}bcm.tmc.edu
Background—The feasibility of
measuring cavitary electrograms using a noncontact probe and
reconstructing endocardial surface electrograms and activation
sequences during paced beats was previously demonstrated in the
isolated canine left ventricle (LV). The objective of the present
study was to develop and test a high-resolution, three-dimensional,
endocardial electrophysiological imaging
technique that simultaneously reconstructs endocardial
surface electrograms and their corresponding activation sequences
during normal and abnormal beats with the use of cavitary electrograms
measured with a noncontact multielectrode probe in the intact canine
LV.
Methods and Results—A 128-electrode probe was inserted into the
intact canine LV. Probe unipolar electrograms were
simultaneously acquired during sinus, artificially paced,
and spontaneous premature beats. Representative
endocardial electrograms were measured directly using eight needle
electrodes (the "gold standard"). A probe-cavity realistic,
three-dimensional geometric model was constructed using two-dimensional
epicardial echocardiography. Boundary element
methods and numeric regularization were used to compute electrograms at
194 sites on the endocardium. In eight pacing protocols, computed
endocardial electrograms correlated well with directly measured
electrograms (r=.88). Corresponding activation times
were also in agreement with those determined from measured endocardial
electrograms (activation error, 4.7 ms). The earliest region of
activation was invariably in the vicinity of the pacing needle (spatial
error, 9.2 mm). Subsequently, the site of origin of
ischemia-induced spontaneous ventricular premature
beats and the ensuing sequence of depolarization was identified.
Conclusions—Noncontact mapping provides realistic,
three-dimensional electrophysiological
images of the endocardium, on a beat-by-beat basis, that localize the
sites of origin of premature beats and reconstruct their activation
sequences.
© 1998 American Heart Association, Inc.
Basic Science Reports
Three-Dimensional Electrophysiological Imaging of the Intact Canine Left Ventricle Using a Noncontact Multielectrode Cavitary Probe: Study of Sinus, Paced, and Spontaneous Premature Beats
Key Words: electrophysiology • endocardium • mapping
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