Abstract 13432: Noninvasive Cardiac Activation Imaging of Premature Ventricular Contractions in Human Patients
Introduction Noninvasive imaging of cardiac electrical activity is important to aid in ablation therapy of cardiac arrhythmia and cardiovascular research. We present our clinical investigation of a novel three dimensional (3D) cardiac electrical imaging (3DCEI) technique to image premature ventricular contractions (PVCs) in patients undergoing catheter ablation.
Methods Up to 208-channel body surface electrocardiograms (ECGs) were recorded in 5 patients (averaged age 53±22) with symptomatic PVCs. CT scans were performed to build subject-specific heart-torso geometry models. Data analysis was performed on PVCs recorded during body surface potential mapping. The noninvasively-imaged results were compared with the surgical outcome and the activation map obtained from CARTO system during electrophysiological (EP) study.
Results Frequent PVCs (averaged ∼20,000 beats/day) were observed in each patient during Holter monitoring. Ventricular tachycardia was induced during an EP study with the same ECG morphology as the PVCs recorded during Holter monitoring. The ectopic beats initiated by a focal activation pattern primarily from the right ventricular outflow track in four patients, while occasionally from the left coronary cusp in one patient. The noninvasively imaged activation sequence was in good consistency with the CARTO mapping results. Sites of initiation for the analyzed ectopic beats (n=50, averaged QRS duration=112±13ms) were reconstructed to be close (∼10mm) to the last successful ablated sites during EP study.
Conclusions 3DCEI is feasible to image activation sequence and localize the sites of initiation of PVCs in human patients. It may potentially aid in clinical management of cardiac arrhythmias and help understand the mechanisms of these arrhythmias.
- © 2012 by American Heart Association, Inc.