Abstract 19036: Three Dimensional Non-Invasive Imaging of Reentrant Vt in Swine With Myocardial Infarction
Introduction: Reentrant Ventricular Tachycardia (VT) represents a significant clinical challenge for its dynamic nature and hemodynamic instability. Three-dimensional (3D) noninvasive electrical imaging has been shown to successfully image various ventricular arrhythmias arising by a focal mechanism. In this study, we report the first 3D validation of Cardiac Electrical Sparse Imaging (CESI) technique on reentrant VT in swine with myocardial infarction.
Methods: Body surface potential maps (BSPMs) were recorded using up to 128 electrodes in 3 swine with myocardial infarction induced by the occlusion of the left anterior descending coronary artery. Both structural and delay enhancement MRI scans were performed in each animal. Activation sequences were imaged over 30 randomly selected reentry cycles observed simultaneously with 3D intra-cardiac mapping to quantitatively evaluate the performance of the noninvasive imaging.
Results: Good concordance was found between the imaged results and the intra-cardiac recordings. Correlation Coefficient was observed to be 0.79±0.06 and Relative Error 0.22±0.06 between the imaged and intra-cardiac measured activation sequences. The imaged reentry pathways and the slow conduction areas identified were in good agreement with the invasive mapping results and delay enhancement MRI results. The total activation time imaged was on average 218±37ms over the 30 beats compared to the measured 227±21ms. The averaged localization error between the imaged and mapped exit of reentry isthmus was 8.1±1.5mm.
Conclusion: We demonstrate the feasibility, for the first time, that the beat-to-beat 3D activation imaging is capable of imaging and visualizing the cardiac electrical activation during reentrant VT with good accuracy. Noninvasive imaging of reentrant VT holds promise for mechanistic insights into reentrant VT and for improvement in ablation approaches for patients with reentrant VT following myocardial infarction.
Author Disclosures: L. Yu: None. S. Pogwizd: None. G. Walcott: None. T. Yang: None. B. He: None.
- © 2016 by American Heart Association, Inc.