Abstract
Imaging the myocardial activation sequence is critical for improved
diagnosis and treatment of life-threatening cardiac arrhythmias.
It is desirable to reveal the underlying cardiac electrical activity
throughout the three-dimensional (3-D) myocardium (rather than just
the endocardial or epicardial surface) from noninvasive body surface
potential measurements. A new 3-D electrocardiographic imaging technique
(3-DEIT) based on the boundary element method (BEM) and multiobjective
nonlinear optimization has been applied to reconstruct the cardiac
activation sequences from body surface potential maps. Ultrafast
computerized tomography scanning was performed for subsequent construction
of the torso and heart models. Experimental studies were then conducted,
during left and right ventricular pacing, in which noninvasive assessment
of ventricular activation sequence by means of 3-DEIT was performed
simultaneously with 3-D intracardiac mapping (up to 200 intramural
sites) using specially designed plunge-needle electrodes in closed-chest
rabbits. Estimated activation sequences from 3-DEIT were in good
agreement with those constructed from simultaneously recorded intracardiac
electrograms in the same animals. Averaged over 100 paced beats (from
a total of 10 pacing sites), total activation times were comparable
(53.3 +/- 8.1 vs. 49.8 +/- 5.2 ms), the localization error of site
of initiation of activation was 5.73 +/- 1.77 mm, and the relative
error between the estimated and measured activation sequences was
0.32 +/- 0.06. The present experimental results demonstrate that
the 3-D paced ventricular activation sequence can be reconstructed
by using noninvasive multisite body surface electrocardiographic
measurements and imaging of heart-torso geometry. This new 3-D electrocardiographic
imaging modality has the potential to guide catheter-based ablative
interventions for the treatment of life-threatening cardiac arrhythmias.
- 16085677
- algorithms,
- animals,
- body
- computer-assisted,
- conduction
- echocardiography,
- extramural,
- gov't,
- heart
- image
- interpretation,
- mapping,
- n.i.h.,
- non-p.h.s.,
- non-u.s.
- potential
- rabbits,
- research
- research,
- support,
- surface
- system,
- three-dimensional,
- u.s.
- ventricles,
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