Predicting the Origin of Ventricular Arrhythmia Using Acoustic Cardiography

Figures

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  Figure 1. Example of acoustic cardiographic output and electroanatomic mapping in a Group 1 patient with non-outflow tract RV VA. (A) Acoustic cardiographic output including ECG, 2- and 3-D display of time-frequency information. The PVC S1 splitting duration and complexity were smaller than SR beats. (B) 3-D electroanatomic mapping with pacemapping shows a high similarity of QRS morphology located at the right ventricular basal area (red color) where catheter ablation successfully terminated the VA. 3-D, three-dimensional; ECG, electrocardiography; PVC, premature ventricular complex; SR, sinus rhythm; VA, ventricular arrhythmia.

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  Figure 2. Example of acoustic cardiographic output and electroanatomic mapping of a Group 2 patient with non-outflow tract LV VA. (A) Acoustic cardiographic output including ECG, 2- and 3-D display of time-frequency information. The PVC S1 splitting duration and complexity were smaller than SR beats. (B) 3-D electroanatomic mapping with activation map shows that the earliest activation site of VA was located at the left ventricular septum area where pacemapping showed a good correlation and catheter ablation successfully terminated the VA. 3-D, three-dimensional; ECG, electrocardiography; LV, left ventricular; PVC, premature ventricular complex; SR, sinus rhythm; VA, ventricular arrhythmia.

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  Figure 3. Example of acoustic cardiographic output and electroanatomic mapping of a Group 1 patient with RVOT VA. (A) Acoustic cardiographic output including ECG, 2- and 3-D display of time-frequency information. The PVC S1 splitting duration and complexity were smaller than SR beats. (B) 3-D electroanatomic mapping with activation map shows that the earliest activation site of the VA was located at the RVOT septum area where catheter ablation successfully terminated the VA. 3-D, three-dimensional; ECG, electrocardiography; PVC, premature ventricular complex; SR, sinus rhythm; RVOT, right ventricular outflow tract; VA, ventricular arrhythmia. 3-D, three-dimensional; PVC, premature ventricular complex; SR, sinus rhythm; RVOT, right ventricular outflow tract; VA, ventricular arrhythmia.

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  Figure 4. Scatter plots, Box plots, and ROC curve. (A) Box plot and scatter plot demonstrating the differences and the distribution of PVC S1 Duration of patients with VA originating from different chambers. (B) The ROC curve analysis of the PVC S1 Duration for predicting the VAs origin. (C) Box plot and scatter plot demonstrating the differences and the distribution of [PVC-SR] S1 Complexiity of patients with VA originating from different chambers. (D) The ROC curve analysis of the [PVC-SR] S1 Complexiity for predicting the VAs origin. (E) Box plot and scatter plot demonstrating the differences and the distribution of [PVC-SR] S1 Duration of patients with VA originating from different chambers. (F) The ROC curve analysis of the [PVC-SR] S1 Duration for predicting the VAs origin. AUC, area under the curve of ROC; LV, left ventricle; PVC, premature ventricular complex; ROC, receiver operating characteristic curve; RV, right ventricle; S1, first heart sound; S2, second heart sound; SR, sinus rhythm; VA, ventricular arrhythmia. Box plot explanation: upper horizontal line of box, 75th percentile; lower horizontal line of box, 25th percentile; horizontal bar within box, median; upper horizontal…

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  Figure 5. ROC curve analysis for predicting the OT VAs or non-OT Vas. (A) The ROC curve analysis of the [PVC-SR] S1 intensity for predicting the area of origin in the left ventricle. (B) The ROC curve analysis of the [PVC-SR] S1 intensity for predicting the area of origin in the right ventricle. AUC, area under the curve of ROC; PVC, premature ventricular complex; ROC, receiver operating characteristic curve; S1, first heart sound; S2, second heart sound; SR, sinus rhythm; VA, ventricular arrhythmia.