ECG imaging of ventricular tachycardia: evaluation against simultaneous non-contact mapping and CMR-derived grey zone
Résumé
ECG imaging is an emerging technology for the
reconstruction of cardiac electric activity from non-invasively measured body surface potential maps. In this case
report, we present the first evaluation of transmurally
imaged activation times against endocardially reconstructed isochrones for a case of sustained monomorphic
ventricular tachycardia (VT). Computer models of the
thorax and whole heart were produced from MR images. A
recently published approach was applied to facilitate
electrode localization in the catheter laboratory, which
allows for the acquisition of body surface potential maps
while performing non-contact mapping for the reconstruction of local activation times. ECG imaging was then
realized using Tikhonov regularization with spatio-temporal smoothing as proposed by Huiskamp and Greensite and
further with the spline-based approach by Erem et al.
Activation times were computed from transmurally
reconstructed transmembrane voltages. The results showed
good qualitative agreement between the non-invasively and
invasively reconstructed activation times. Also, low
amplitudes in the imaged transmembrane voltages were
found to correlate with volumes of scar and grey zone in
delayed gadolinium enhancement cardiac MR. The study
underlines the ability of ECG imaging to produce activation times of ventricular electric activity—and to represent
effects of scar tissue in the imaged transmembrane
voltages.
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