Activation patterns during selective pacing of the left ventricle can be characterized using noninvasive electrocardiographic imaging

HJ Shannon, CO Navarro, BA Smith, AJ McClelland, EW Lau, MJD Roberts, JMCC Anderson, JJA Adgey

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Noncontact endocardial mapping allows accurate beat-to-beat reconstruction of the reentrant pathway of ventricular tachycardia and improves outcomes after ablation. Several studies support electrocardiographic imaging (ECGI) as a means of noninvasively outlining epicardial activation despite constraints of internal geometry. However, few have explored its clinical application. This study aims to evaluate ECGI during selective left ventricular (LV) pacing, relative to an invasive approach.Multisite pacing was performed within the left ventricles of 3 patients undergoing invasive procedures. Simultaneous recording of endocardial potentials using a noncontact multielectrode array and body surface potentials (BSP) using an 80-electrode torso vest was performed. A total of 16 recordings were made. The inverse solution was applied to BSP to reconstruct epicardial activation. Single-paced beats from real and virtual electrograms were used to construct 3-dimensional isochronal and isopotential maps. Endocardial and epicardial data were then superimposed onto a single geometry to allow quantitative comparison of activation foci.Good correlation was observed between endocardial activation patterns and those reconstructed from BSP using ECGI. This was repeatedly demonstrated in all LV regions except for the septum (3 recordings). Epicardial isochronal maps were able to locate early and late activation to mean distances of 13.8 +/- 4.7 and 12.5 +/- 3.7 mm from endocardial data. Isopotential maps localized pacing sites with comparable accuracy (14 +/- 5.3 mm).Body surface potentials and reconstructed epicardial activation patterns during LV pacing correlate well with endocardial data acquired invasively. The exception was during pacing of the septum. Although early results are encouraging, further quantitative data are required to fully validate and apply this noninvasive tool in the clinical arena.
LanguageEnglish
PagesS111-S117
JournalJournal of Electrocardiology
Volume40
Issue number6 Supp
Publication statusPublished - Nov 2007

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Torso
Ventricular Tachycardia
Heart Ventricles
Electrodes

Keywords

  • Aged
  • Body Surface Potential Mapping: methods
  • Cardiac Pacing
  • Artificial: methods
  • Diagnosis
  • Computer-Assisted: methods
  • Diagnostic Imaging: methods
  • Electrocardiography: methods
  • Humans
  • Male
  • Middle Aged
  • Ventricular Dysfunction
  • Left: diagnosis
  • Left: prevention &amp
  • control

Cite this

Shannon, HJ., Navarro, CO., Smith, BA., McClelland, AJ., Lau, EW., Roberts, MJD., ... Adgey, JJA. (2007). Activation patterns during selective pacing of the left ventricle can be characterized using noninvasive electrocardiographic imaging. Journal of Electrocardiology, 40(6 Supp), S111-S117.
Shannon, HJ ; Navarro, CO ; Smith, BA ; McClelland, AJ ; Lau, EW ; Roberts, MJD ; Anderson, JMCC ; Adgey, JJA. / Activation patterns during selective pacing of the left ventricle can be characterized using noninvasive electrocardiographic imaging. In: Journal of Electrocardiology. 2007 ; Vol. 40, No. 6 Supp. pp. S111-S117.
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abstract = "Noncontact endocardial mapping allows accurate beat-to-beat reconstruction of the reentrant pathway of ventricular tachycardia and improves outcomes after ablation. Several studies support electrocardiographic imaging (ECGI) as a means of noninvasively outlining epicardial activation despite constraints of internal geometry. However, few have explored its clinical application. This study aims to evaluate ECGI during selective left ventricular (LV) pacing, relative to an invasive approach.Multisite pacing was performed within the left ventricles of 3 patients undergoing invasive procedures. Simultaneous recording of endocardial potentials using a noncontact multielectrode array and body surface potentials (BSP) using an 80-electrode torso vest was performed. A total of 16 recordings were made. The inverse solution was applied to BSP to reconstruct epicardial activation. Single-paced beats from real and virtual electrograms were used to construct 3-dimensional isochronal and isopotential maps. Endocardial and epicardial data were then superimposed onto a single geometry to allow quantitative comparison of activation foci.Good correlation was observed between endocardial activation patterns and those reconstructed from BSP using ECGI. This was repeatedly demonstrated in all LV regions except for the septum (3 recordings). Epicardial isochronal maps were able to locate early and late activation to mean distances of 13.8 +/- 4.7 and 12.5 +/- 3.7 mm from endocardial data. Isopotential maps localized pacing sites with comparable accuracy (14 +/- 5.3 mm).Body surface potentials and reconstructed epicardial activation patterns during LV pacing correlate well with endocardial data acquired invasively. The exception was during pacing of the septum. Although early results are encouraging, further quantitative data are required to fully validate and apply this noninvasive tool in the clinical arena.",
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Shannon, HJ, Navarro, CO, Smith, BA, McClelland, AJ, Lau, EW, Roberts, MJD, Anderson, JMCC & Adgey, JJA 2007, 'Activation patterns during selective pacing of the left ventricle can be characterized using noninvasive electrocardiographic imaging', Journal of Electrocardiology, vol. 40, no. 6 Supp, pp. S111-S117.

Activation patterns during selective pacing of the left ventricle can be characterized using noninvasive electrocardiographic imaging. / Shannon, HJ; Navarro, CO; Smith, BA; McClelland, AJ; Lau, EW; Roberts, MJD; Anderson, JMCC; Adgey, JJA.

In: Journal of Electrocardiology, Vol. 40, No. 6 Supp, 11.2007, p. S111-S117.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Activation patterns during selective pacing of the left ventricle can be characterized using noninvasive electrocardiographic imaging

AU - Shannon, HJ

AU - Navarro, CO

AU - Smith, BA

AU - McClelland, AJ

AU - Lau, EW

AU - Roberts, MJD

AU - Anderson, JMCC

AU - Adgey, JJA

N1 - LR: 20091111RX: 850816 (on Jul 22, 2011)

PY - 2007/11

Y1 - 2007/11

N2 - Noncontact endocardial mapping allows accurate beat-to-beat reconstruction of the reentrant pathway of ventricular tachycardia and improves outcomes after ablation. Several studies support electrocardiographic imaging (ECGI) as a means of noninvasively outlining epicardial activation despite constraints of internal geometry. However, few have explored its clinical application. This study aims to evaluate ECGI during selective left ventricular (LV) pacing, relative to an invasive approach.Multisite pacing was performed within the left ventricles of 3 patients undergoing invasive procedures. Simultaneous recording of endocardial potentials using a noncontact multielectrode array and body surface potentials (BSP) using an 80-electrode torso vest was performed. A total of 16 recordings were made. The inverse solution was applied to BSP to reconstruct epicardial activation. Single-paced beats from real and virtual electrograms were used to construct 3-dimensional isochronal and isopotential maps. Endocardial and epicardial data were then superimposed onto a single geometry to allow quantitative comparison of activation foci.Good correlation was observed between endocardial activation patterns and those reconstructed from BSP using ECGI. This was repeatedly demonstrated in all LV regions except for the septum (3 recordings). Epicardial isochronal maps were able to locate early and late activation to mean distances of 13.8 +/- 4.7 and 12.5 +/- 3.7 mm from endocardial data. Isopotential maps localized pacing sites with comparable accuracy (14 +/- 5.3 mm).Body surface potentials and reconstructed epicardial activation patterns during LV pacing correlate well with endocardial data acquired invasively. The exception was during pacing of the septum. Although early results are encouraging, further quantitative data are required to fully validate and apply this noninvasive tool in the clinical arena.

AB - Noncontact endocardial mapping allows accurate beat-to-beat reconstruction of the reentrant pathway of ventricular tachycardia and improves outcomes after ablation. Several studies support electrocardiographic imaging (ECGI) as a means of noninvasively outlining epicardial activation despite constraints of internal geometry. However, few have explored its clinical application. This study aims to evaluate ECGI during selective left ventricular (LV) pacing, relative to an invasive approach.Multisite pacing was performed within the left ventricles of 3 patients undergoing invasive procedures. Simultaneous recording of endocardial potentials using a noncontact multielectrode array and body surface potentials (BSP) using an 80-electrode torso vest was performed. A total of 16 recordings were made. The inverse solution was applied to BSP to reconstruct epicardial activation. Single-paced beats from real and virtual electrograms were used to construct 3-dimensional isochronal and isopotential maps. Endocardial and epicardial data were then superimposed onto a single geometry to allow quantitative comparison of activation foci.Good correlation was observed between endocardial activation patterns and those reconstructed from BSP using ECGI. This was repeatedly demonstrated in all LV regions except for the septum (3 recordings). Epicardial isochronal maps were able to locate early and late activation to mean distances of 13.8 +/- 4.7 and 12.5 +/- 3.7 mm from endocardial data. Isopotential maps localized pacing sites with comparable accuracy (14 +/- 5.3 mm).Body surface potentials and reconstructed epicardial activation patterns during LV pacing correlate well with endocardial data acquired invasively. The exception was during pacing of the septum. Although early results are encouraging, further quantitative data are required to fully validate and apply this noninvasive tool in the clinical arena.

KW - Aged

KW - Body Surface Potential Mapping: methods

KW - Cardiac Pacing

KW - Artificial: methods

KW - Diagnosis

KW - Computer-Assisted: methods

KW - Diagnostic Imaging: methods

KW - Electrocardiography: methods

KW - Humans

KW - Male

KW - Middle Aged

KW - Ventricular Dysfunction

KW - Left: diagnosis

KW - Left: prevention &amp

KW - control

M3 - Article

VL - 40

SP - S111-S117

JO - Journal of Electrocardiology

T2 - Journal of Electrocardiology

JF - Journal of Electrocardiology

SN - 0022-0736

IS - 6 Supp

ER -