Noninvasive ECG imaging (ECGI): Mapping the arrhythmic substrate of the human heart

Rudy, Yoram

doi:10.1016/j.ijcard.2017.02.104

Cited by 31 publications

(19 citation statements)

References 11 publications

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“…The newly developed ECG imaging (ECGI) modality provides a promising technology for high-resolution mapping of the electrical and magnetic dynamics of the heart in normal and pathological conditions (Ramanathan et al, 2003; Intini et al, 2005; Rudy, 2017). This approach uses an array of networked electrodes to directly reconstruct the electrophysiological activity of the heart by using the full body surface potential (BSP) and solving the inverse problem in electrocardiography.…”

Section: Introductionmentioning

confidence: 99%

ECG Imaging to Detect the Site of Ventricular Ischemia Using Torso Electrodes: A Computational Study

Kara

Alday

et al. 2019

Front. Physiol.

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Electrocardiography provides some information useful for ischemic diagnosis. However, more recently there has been substantial growth in the area of ECG imaging, which by solving the inverse problem of electrocardiography aims to produce high-resolution mapping of the electrical and magnetic dynamics of the heart. Most inverse studies use the full resolution of the body surface potential (BSP) to reconstruct the epicardial potentials, however using a limited number of torso electrodes to interpolate the BSP is more clinically relevant and has an important effect on the reconstruction which must be quantified. A circular ischemic lesion on the right ventricle lateral wall 27 mm in radius is reconstructed using three Tikhonov methods along with 6 different electrode configurations ranging from 32 leads to 1,024 leads. The 2nd order Tikhonov solution performed the most accurately (~80% lesion identified) followed by the 1st (~50% lesion identified) and then the 0 order Tikhonov solution performed the worst with a maximum of ~30% lesion identified regardless of how many leads were used. With an increasing number of leads the solution produces less error, and the error becomes more localised around the lesion for all three regularisation methods. In noisy conditions, the relative performance gap of the 1st and 2nd order Tikhonov solutions was reduced, and determining an accurate regularisation parameter became relatively more difficult. Lesions located on the left ventricle walls were also able to be identified but comparatively to the right ventricle lateral wall performed marginally worse with lesions located on the interventricular septum being able to be indicated by the reconstructions but not successfully identified against the error. The quality of reconstruction was found to decrease as the lesion radius decreased, with a lesion radius of <20 mm becoming difficult to correctly identify against the error even when using >512 torso electrodes.

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Section: Introductionmentioning

confidence: 99%

ECG Imaging to Detect the Site of Ventricular Ischemia Using Torso Electrodes: A Computational Study

Kara

Alday

et al. 2019

Front. Physiol.

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“…Adapted from Rudy et al . 10 CT, computed tomography; ECGi, electrocardiographic imaging; MRI, magnetic resonance imaging. Author's permission granted and RightsLink License number 4851570792908.…”

Section: Electrocardiographic Imagingmentioning

confidence: 99%

Electrocardiographic imaging for cardiac arrhythmias and resynchronization therapy

2020

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Use of the 12-lead electrocardiogram (ECG) is fundamental for the assessment of heart disease, including arrhythmias, but cannot always reveal the underlying mechanism or the location of the arrhythmia origin. Electrocardiographic imaging (ECGi) is a non-invasive multi-lead ECG-type imaging tool that enhances conventional 12-lead ECG. Although it is an established technology, its continuous development has been shown to assist in arrhythmic activation mapping and provide insights into the mechanism of cardiac resynchronization therapy (CRT). This review addresses the validity, reliability, and overall feasibility of ECGi for use in a diverse range of arrhythmias. A systematic search limited to full-text human studies published in peer-reviewed journals was performed through Medline via PubMed, using various combinations of three key concepts: ECGi, arrhythmia, and CRT. A total of 456 studies were screened through titles and abstracts. Ultimately, 42 studies were included for literature review. Evidence to date suggests that ECGi can be used to provide diagnostic insights regarding the mechanistic basis of arrhythmias and the location of arrhythmia origin. Furthermore, ECGi can yield valuable information to guide therapeutic decision-making, including during CRT. Several studies have used ECGi as a diagnostic tool for atrial and ventricular arrhythmias. More recently, studies have tested the value of this technique in predicting outcomes of CRT. As a non-invasive method for assessing cardiovascular disease, particularly arrhythmias, ECGi represents a significant advancement over standard procedures in contemporary cardiology. Its full potential has yet to be fully explored.

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“…More specifically, proof of concept studies 48 Finally, a novel approach in congenital long QT syndrome diagnosis and also arrhythmic risk stratification (but theoretically applicable to acquired forms as well) is based on the application of ECG imaging. 49 This technique fuses anatomical data from ECG-gated chest CT with a 256-lead surface ECG (whereupon an electrode-loaded chest plate is used) to produce >500 unipolar epicardial ECGs, 50…”

Section: Diagnosis Of Qt Prolongation and Risk Stratificationmentioning

confidence: 99%

QT Prolongation and Malignant Arrhythmia: How Serious a Problem?

Antoniou

Dilaveris

Manolakou

et al. 2017

European Cardiology Review

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QT prolongation constitutes one of the most frequently encountered electrical disorders of the myocardium. This is due not only to the presence of several associated congenital syndrome but also, and mainly, due to the QT-prolonging effects of several acquired conditions, such as ischaemia and heart failure, as well as multiple medications from widely different categories. Propensity of repolarization disturbances to arrhythmia appears to be inherent in the function of and electrophysiology of the myocardium. In the present review the issue of QT prolongation will be addressed in terms of pathophysiology, arrhythmogenesis, treatment and risk stratification approaches. Although already discussed in literature, it is hoped that the mechanistic approach of the present review will assist in improved understanding of the underlying changes in electrophysiology, as well as the rationale for current diagnostic and therapeutic approaches.

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Noninvasive ECG imaging (ECGI): Mapping the arrhythmic substrate of the human heart

Cited by 31 publications

References 11 publications

ECG Imaging to Detect the Site of Ventricular Ischemia Using Torso Electrodes: A Computational Study

ECG Imaging to Detect the Site of Ventricular Ischemia Using Torso Electrodes: A Computational Study

Electrocardiographic imaging for cardiac arrhythmias and resynchronization therapy

QT Prolongation and Malignant Arrhythmia: How Serious a Problem?

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