Mapping of ventricular arrhythmias using a novel noninvasive epicardial and endocardial electrophysiology system

INTRODUCTION: The aim of this study was to assess the use of a novel noninvasive epicardial and endocardial electrophysiology system (NEEES) for mapping of ventricular arrhythmias. METHODS: Eight patients (2 females, mean age 50±17 years) with ischemic (n=3) and nonischemic (n=5) cardiomyopathy and inducible ventricular arrhythmias during electrophysiology study were enrolled. Noninvasive mapping of ventricular arrhythmias was performed using the NEEES based on body-surface electrocardiograms and computed tomography imaging data. Arrhythmia patterns were analyzed using noninvasive phase mapping. RESULTS: Macro-reentrant VT circuits were observed in 3 ischemic and 1 nonischemic cardiomyopathy patient, respectively. In the remaining 4 patients, phase mapping revealed relatively stable rotor activity and multiple wavelets. CONCLUSIONS: Noninvasive cardiac mapping was able to visualize the macro-reentrant circuits in patients with scar-related VT. In patients without myocardial scar only polymorphic VT or VF was inducible, and rotor activity and multiple wavelets were observed.