Key result
Noninvasive localization of premature ventricular complex origins using a single dipole model achieved a mean localization error of 5.2 mm with 300 torso nodes and 5.3 mm with 192 mapping leads.
A simulation study demonstrates that an inverse solution method can accurately localize PVC origins noninvasively, with comparable accuracy using 192 mapping leads versus 300 torso nodes.
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Simulation supports dipole-based PVC localization feasibility; leaves open clinical accuracy and adoption pending patient validation.
The accuracy of a method for noninvasive localization of the origin of premature ventricular complex (PVC) was tested on simulated data. The method is based on inverse solution in terms of a single dipole that uses integrals of body surface potentials (BSPs) and a model of the torso volume conductor. ECGSIM software was used to simulate ectopic activation in a realistic ventricular model and BSPs on an inhomogeneous torso. Ectopic activation origins were simulated in 120 positions located in anterior, lateral, posterior, and septal segments of the right and left ventricle (RV, LV). In both septal segments 15 endocardial positions were specified, in all other segments 5 epicardial, 5 endocardial, and 5 in the valvular region were defined. Corresponding BSPs for initial 5 ms interval of the ectopic activity were simulated in 300 torso nodes as well as in 192 points representing BSP mapping leads. Simulated BSPs and the torso model with lungs and heart cavities were then used for the inverse localization of each PVC origin. The localization error (LE) was defined as the distance between the simulated and inversely estimated PVC origin position. All simulated PVC origins were localized in the correct ventricular segment. There was no significant difference between the LEs in the RV and LV, except the septal segments where the LE was significantly smaller in the RV (p<0.05). There were no significant differences between the LEs obtained using BSP maps from 300 torso nodes or 192 mapping leads (mean values LE300=5.2±4.4 mm and LE192=5.3±4.5 mm).
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Deutsch et al. (2018) studied Premature ventricular complex (n=120). Noninvasive localization using 300 torso nodes vs. Noninvasive localization using 192 mapping leads was evaluated on Localization error (distance between simulated and inversely estimated PVC origin). Noninvasive localization of premature ventricular complex origins using a single dipole model achieved a mean localization error of 5.2 mm with 300 torso nodes and 5.3 mm with 192 mapping leads.
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