Abstract 17832: A New Rapid Vector Technique to Localize the PVC Origin From the 12-lead Ecg Compared to Cips
Introduction: Prior accurate PVC localization improves the time and outcome of ablative procedures. We developed a new manual Vector Technique (VcT) to localize the PVC origin to cardiac anatomy regions. In contrast, our Cardiac Isochrone Positioning System (CIPS) is a computer based system that localizes the PVC to patient specific cardiac anatomy from the MRI and electrode positions from the 3D Camera.
Hypothesis: We hypothesize that this new VcT can rapidly quantitate the location of PVC to anatomical regions whereas CIPS localizes the PVCs to more specific cardiac anatomical segments.
Method: The VcT assumes the frontal plane leads are formatted on the chest as an equilateral triangle and the horizontal leads as a partial sphere. Using the concept that a lead recording perpendicular to a dipole vector is zero, the QRS axis vectors of the PVC were calculated manually within 3.8 to 7.5 degrees in the frontal and horizontal planes.
CIPS computed the electrode positions by registration of the MRI derived torso model with the 3D image of the patient. The ECG signals were used by both methods to localize the PVC origin to the cardiac anatomy.
Result: In 12 patients (below), this manual VcT separated without overlap in the horizontal plane the PVC into Left Ventricle (LV 30-45°), Right Ventricular (RV 308-348°), and Papillary Muscle (PM 128-150°) regions, but not in the frontal plane. CIPS localized 10 PVCs to the same and 2 to adjacent anatomical segments while the vector technique cannot because of the need for a database to create a PVC anatomic segment model.
Conclusion: This new VcT can be used by anyone to localize rapidly the PVC by a QRS vector plot to regions like the left & posterior for the RV, left & anterior for the LV, and right & anterior for the papillary muscles while CIPS can localize PVCs more specifically to anatomical segments. Using the 12 lead ECG, this VcT creates a quantitative cardiac anatomical segment model of PVC locations integrated into CIPS that can improve the accuracy of VcT.
Author Disclosures: P.M. van Dam: Employment; Significant; Peacs, Radboud University Nijmegen. J.P. Gordon: None. R. Tung: None. N.G. Boyle: None. M.M. Laks: None.
- © 2015 by American Heart Association, Inc.