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ECG imaging of ventricular tachycardia: evaluation against simultaneous non-contact mapping and CMR-derived grey zone

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Abstract

ECG imaging is an emerging technology for the reconstruction of cardiac electric activity from non-invasively measured body surface potential maps. In this case report, we present the first evaluation of transmurally imaged activation times against endocardially reconstructed isochrones for a case of sustained monomorphic ventricular tachycardia (VT). Computer models of the thorax and whole heart were produced from MR images. A recently published approach was applied to facilitate electrode localization in the catheter laboratory, which allows for the acquisition of body surface potential maps while performing non-contact mapping for the reconstruction of local activation times. ECG imaging was then realized using Tikhonov regularization with spatio-temporal smoothing as proposed by Huiskamp and Greensite and further with the spline-based approach by Erem et al. Activation times were computed from transmurally reconstructed transmembrane voltages. The results showed good qualitative agreement between the non-invasively and invasively reconstructed activation times. Also, low amplitudes in the imaged transmembrane voltages were found to correlate with volumes of scar and grey zone in delayed gadolinium enhancement cardiac MR. The study underlines the ability of ECG imaging to produce activation times of ventricular electric activity—and to represent effects of scar tissue in the imaged transmembrane voltages.

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Acknowledgments

Rashed Karim was funded by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust and King's College London. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

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  1. Martin W. Krueger

    Present address: ABB AG, Corporate Research, Ladenburg, Germany

Authors and Affiliations

  1. Institute of Biomedical Engineering, Karlsruhe Institute of Technology (KIT), Kaiserstr. 12, 76131, Karlsruhe, Germany

    Walther H. W. Schulze, Danila Potyagaylo, Martin W. Krueger & Olaf Dössel

  2. Division of Imaging Sciences, St. Thomas’ Hospital, King’s College London, London, UK

    Zhong Chen, Rashed Karim, Manav Sohal, Anoop Shetty, YingLiang Ma, Julian Bostock, Reza Razavi, Kawal S. Rhode & Christopher A. Rinaldi

  3. INRIA Sophia Antipolis, Sophia Antipolis, France

    Jatin Relan, Nicholas Ayache, Maxime Sermesant & Herve Delingette

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  1. Walther H. W. Schulze
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Correspondence to Walther H. W. Schulze.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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The research leading to these results was co-funded by the European Commission within the Seventh Framework Programme (FP7/2007-2013) under Grant Agreement No. 224495 (euHeart project) and by the German Research Foundation under grants DO637/10-1 and DO637/13-1.

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Schulze, W.H.W., Chen, Z., Relan, J. et al. ECG imaging of ventricular tachycardia: evaluation against simultaneous non-contact mapping and CMR-derived grey zone. Med Biol Eng Comput 55, 979–990 (2017). https://doi.org/10.1007/s11517-016-1566-x

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