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February 26, 2019Frontiers in Physiology14 citationsOpen Access

Optical Imaging of Ventricular Action Potentials in a Torso Tank: A New Platform for Non-Invasive Electrocardiographic Imaging Validation

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LBLaura BearRWRichard D. WaltonEAEmma Abell

Key Result

A novel experimental setup combining a human-shaped torso tank with optical mapping accurately validated ECGI reconstructions of activation patterns (correlation 0.79) in ex vivo pig hearts.

Structured PICO

Does a novel experimental setup combining a human-shaped torso tank with optical mapping accurately validate ECGI reconstructions of cardiac activation and repolarization in Langendorff-perfused pig hearts?

P
Population
Langendorff-perfused pig hearts (n=3) suspended in a human torso-shaped tank
I
Intervention
Non-invasive electrocardiographic imaging (ECGI) reconstruction from torso potentials
C
Comparator
High-resolution optical mapping and 108-electrode epicardial sock recordings
O
Outcome
Accuracy of ECGI reconstructions of activation and repolarization patterns and gradientssurrogate

A novel experimental platform combining a torso tank with optical mapping successfully validates non-invasive electrocardiographic imaging of ventricular activation and repolarization.

Limitations

  • Field of view of the optical mapping window was limited to approximately 10 cm x 10 cm, only capturing the anterior surface of the heart.
  • Necessity of electro-mechanical uncoupling removes contraction present in clinical applications.
  • Use of an ex vivo model and torso tank with uniform isotropic electrical properties, unlike in vivo conditions.
  • Low sample size (n=3) limits insight into inter-heart variability.

Abstract

Background: Non-invasive electrocardiographic imaging (ECGI) is a promising tool to provide high-resolution panoramic imaging of cardiac electrical activity noninvasively from body surface potential measurements. Current experimental methods for ECGI validation are limited to comparison with unipolar electrograms and the relatively low spatial resolution of cardiac mapping arrays. We aim to develop a novel experimental set up combining a human shaped torso tank with high-resolution optical mapping allowing the validation of ECGI reconstructions. Methods: Langendorff-perfused pig hearts (n=3) were suspended in a human torso-shaped tank, with the LAD cannulated on a separate perfusion. Electrical signals were recorded from an 108-electrode epicardial sock and 128 electrodes embedded in the tank surface. Simultaneously, optical mapping of the heart was performed through the anterior surface of the tank. Recordings were made in sinus rhythm and ventricular pacing (n=55), with activation and repolarization heterogeneities induced by perfusion of hot and cold solutions as well as Sotalol through the LAD. Fluoroscopy provided 3D cardiac and electrode geometries in the tank that were transformed to the 2D optical mapping window using an optimization algorithm. Epicardial unipolar electrograms were reconstructed from torso potentials using ECGI and validated using optical activation and repolarization maps. Results: The transformation and alignment of the 3D geometries onto the 2D optical mapping window was good with an average correlation of 0.87±0.10 and error of 7.7±3.1 ms with activation derived from the sock. The difference in repolarization times were more substantial (error = 17.4±3.7 ms) although the sock and optical repolarization patterns themselves were very similar (correlation = 0.83±0.13). Validation of ECGI reconstructions revealed ECGI accurately captures the pattern of activation (correlation = 0.79±0.11) and identified regions of late and/or early repolarization during different perfusions through LAD. ECGI also correctly demonstrated gradients in both activation and repolarization, although in some cases these were under or over-estimated or shifted slightly in space. Conclusion: A novel experimental setup has been developed, combining a human-shaped torso tank with optical mapping, which can be effectively used in the validation of ECGI techniques; including the reconstruction of activation and repolarization patterns and gradients.

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Cite This Study

Bear et al. (2019) studied Experimental ECGI validation (n=3). Electrocardiographic imaging (ECGI) vs. Optical mapping and epicardial sock electrodes was evaluated on Correlation of activation times between ECGI and optical mapping. A novel experimental setup combining a human-shaped torso tank with optical mapping accurately validated ECGI reconstructions of activation patterns (correlation 0.79) in ex vivo pig hearts.

synapsesocial.com/papers/6a0e9faf2eca052da647a13dhttps://doi.org/10.3389/fphys.2019.00146
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