Je. Burnes et al., Noninvasive electrocardiographic imaging of substrate and intramural ventricular tachycardia in infarcted hearts, J AM COL C, 38(7), 2001, pp. 2071-2078
Citations number
17
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
OBJECTIVES The goal of this study was to experimentally evaluate a novel no
ninvasive electrocardiographic imaging modality during intramural reentrant
ventricular tachycardia (VT).
BACKGROUND Myocardial infarction and subsequent remodeling produce abnormal
electrophysiologic substrates capable of initiating and maintaining reentr
ant arrhythmias. Existing noninvasive electrocardiographic methods cannot c
haracterize abnormal electrophysiologic substrates in the heart or the deta
ils of associated arrhythmias. A noninvasive method with such capabilities
is needed to identify patients at risk of arrhythmias and to guide and eval
uate therapy.
METHODS A dog heart with a four-day-old infarction was suspended in a human
shaped torso-tank. Measured body surface potentials were used to noninvasi
vely compute epicardial potentials, electrograms and isochrones. Accuracy o
f reconstruction was evaluated by direct comparison to measured data. Recon
structions were performed during right atrial pacing and nine cycles of VT.
RESULTS Noninvasively reconstructed potential maps, electrograms and isochr
ones identified: 1) the location of electrophysiologically abnormal infarct
substrate; 2) the epicardial activation sequences during the VTs; 3) the l
ocations of epicardial breakthrough sites; and 4) electrophysiologic eviden
ce for activation of the Purkinje system and septum during the reentrant be
ats.
CONCLUSIONS Electrocardiographic imaging can noninvasively reconstruct elec
trophysiologic information on the epicardium during VT with intramural reen
try, provide information about the location of the intramural components of
reentry and image abnormal electrophysiologic substrates associated with i
nfarction. (J Am Coll Cardiol 2001;38:2071-8) (C) 2001 by the American Coll
ege of Cardiology.