Experimental Validation of Noninvasive Epicardial and Endocardial Activation Imaging

• DOI: 10.1161/circep.116.004104
• Publication Date: 2016-07-21T03:38:43Z
• Authors: Peter Oosterhoff; Veronique M.F. Me...; Peter M. van Dam; Pascal F.H.M. van...; Charly N.W. Belte...; Geert J. Streekstra; Jacques M.T. de B...; Ruben Coronel; Thom F. Oostendorp
• Keywords: Cardiac Catheterization; Swine; Body Surface Potential Mapping; Radboudumc 3: Disorders of movement DCMN: Donders Center for Medical Neuroscience; Electrocardiography; 03 medical and health sciences; Imaging, Three-Dimensional; 0302 clinical medicine; Heart Conduction System; Fluoroscopy; Animals; Tomography, X-Ray Computed; Pericardium; Endocardium

Noninvasive imaging of cardiac activation before ablation the arrhythmogenic substrate can reduce electrophysiological procedure duration and help choosing between an endocardial or epicardial approach. A noninvasive technique was evaluated that estimates both from body surface potential maps. We performed a study in isolated situ pig hearts, estimating maps during sinus rhythm localizing stimulation sites.From 3 Langendorff-perfused 180 intramural unipolar electrograms were recorded ectopic activation, together with pseudo-body map ECGs 2 them. From 4 other anesthetized pigs, 64-lead ventricular 27 sites. The pattern computed QRS complexes. For calculated patterns showed good qualitative correspondence to obtained needle electrodes. Absolute timing difference for 10±5 11±8 ms respectively, 6±5 7±6 ms, respectively. Calculated hearts similar hearts. During stimulation, distance site earliest 18 (15-27) mm, 23 sites correctly mapped either endocardium epicardium.Noninvasive is able determine discriminate origin clinically relevant accuracy.