Key result
Novel 3-D cardiac activation imaging localizes PVC initiation sites within ~8 mm of successful ablation.
Why the study?
Does a novel 3-D cardiac activation imaging technique accurately localize the origins of focal ventricular arrhythmias compared to invasive CARTO mapping in patients with PVCs undergoing ablation?
Observational (n=13)
Does a novel 3-D cardiac activation imaging technique accurately localize the origins of focal ventricular arrhythmias compared to invasive CARTO mapping in patients with PVCs undergoing ablation?
Effect estimate: correlation coefficient 0.79
A novel 3-D cardiac activation imaging technique accurately localizes the origins of premature ventricular contractions noninvasively, correlating well with invasive CARTO mapping.
May support noninvasive PVC localization; leaves open prospective validation before clinical adoption.
OBJECTIVE: Noninvasive imaging of cardiac electrical activity promises to provide important information regarding the underlying arrhythmic substrates for successful ablation intervention and further understanding of the mechanism of such lethal disease. The aim of this study is to evaluate the performance of a novel 3-D cardiac activation imaging technique to noninvasively localize and image origins of focal ventricular arrhythmias in patients undergoing radio frequency ablation. METHODS: Preprocedural ECG gated contrast enhanced cardiac CT images and body surface potential maps were collected from 13 patients within a week prior to the ablation. The electrical activation images were estimated over the 3-D myocardium using a cardiac electric sparse imaging technique, and compared with CARTO activation maps and the ablation sites in the same patients. RESULTS: Noninvasively-imaged activation sequences were consistent with the CARTO mapping results with an average correlation coefficient of 0.79, average relative error of 0.19, and average relative resolution error of 0.017. The imaged initiation sites of premature ventricular contractions (PVCs) were, on average, within 8 mm of the last successful ablation site and within 3 mm of the nearest ablation site. CONCLUSION: The present results demonstrate the excellent performance of the 3-D cardiac activation imaging technique in imaging the activation sequence associated with PVC, and localizing the initial sites of focal ventricular arrhythmias in patients. These promising results suggest that the 3-D cardiac activation imaging technique may become a useful tool for aiding clinical diagnosis and management of ventricular arrhythmias.
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Yu et al. (2017) conducted an observational in Premature ventricular contractions (n=13). 3-D cardiac activation imaging technique vs. CARTO activation maps and ablation sites was evaluated on Consistency of noninvasively-imaged activation sequences with CARTO mapping results and distance to ablation sites (correlation coefficient 0.79). A novel 3-D cardiac activation imaging technique accurately localized premature ventricular contraction initiation sites within an average of 8 mm of the last successful ablation site.
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