Document Detail


Noninvasive reconstruction of the three-dimensional ventricular activation sequence during pacing and ventricular tachycardia in the canine heart.
MedLine Citation:
PMID:  21984548     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Single-beat imaging of myocardial activation promises to aid in both cardiovascular research and clinical medicine. In the present study we validate a three-dimensional (3D) cardiac electrical imaging (3DCEI) technique with the aid of simultaneous 3D intracardiac mapping to assess its capability to localize endocardial and epicardial initiation sites and image global activation sequences during pacing and ventricular tachycardia (VT) in the canine heart. Body surface potentials were measured simultaneously with bipolar electrical recordings in a closed-chest condition in healthy canines. Computed tomography images were obtained after the mapping study to construct realistic geometry models. Data analysis was performed on paced rhythms and VTs induced by norepinephrine (NE). The noninvasively reconstructed activation sequence was in good agreement with the simultaneous measurements from 3D cardiac mapping with a correlation coefficient of 0.74 ± 0.06, a relative error of 0.29 ± 0.05, and a root mean square error of 9 ± 3 ms averaged over 460 paced beats and 96 ectopic beats including premature ventricular complexes, couplets, and nonsustained monomorphic VTs and polymorphic VTs. Endocardial and epicardial origins of paced beats were successfully predicted in 72% and 86% of cases, respectively, during left ventricular pacing. The NE-induced ectopic beats initiated in the subendocardium by a focal mechanism. Sites of initial activation were estimated to be ∼7 mm from the measured initiation sites for both the paced beats and ectopic beats. For the polymorphic VTs, beat-to-beat dynamic shifts of initiation site and activation pattern were characterized by the reconstruction. The present results suggest that 3DCEI can noninvasively image the 3D activation sequence and localize the origin of activation of paced beats and NE-induced VTs in the canine heart with good accuracy. This 3DCEI technique offers the potential to aid interventional therapeutic procedures for treating ventricular arrhythmias arising from epicardial or endocardial sites and to noninvasively assess the mechanisms of these arrhythmias.
Authors:
Chengzong Han; Steven M Pogwizd; Cheryl R Killingsworth; Bin He
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Validation Studies     Date:  2011-10-07
Journal Detail:
Title:  American journal of physiology. Heart and circulatory physiology     Volume:  302     ISSN:  1522-1539     ISO Abbreviation:  Am. J. Physiol. Heart Circ. Physiol.     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2011-12-27     Completed Date:  2012-02-14     Revised Date:  2014-09-12    
Medline Journal Info:
Nlm Unique ID:  100901228     Medline TA:  Am J Physiol Heart Circ Physiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  H244-52     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Action Potentials
Animals
Cardiac Pacing, Artificial*
Disease Models, Animal
Dogs
Electrocardiography
Female
Heart Conduction System / physiopathology*,  radiography
Heart Ventricles / physiopathology*,  radiography
Imaging, Three-Dimensional*
Male
Models, Cardiovascular
Norepinephrine
Predictive Value of Tests
Reproducibility of Results
Tachycardia, Ventricular / chemically induced,  diagnosis*,  physiopathology
Time Factors
Tomography, X-Ray Computed
Ventricular Function, Left*
Ventricular Premature Complexes / chemically induced,  diagnosis*,  physiopathology
Voltage-Sensitive Dye Imaging*
Grant Support
ID/Acronym/Agency:
HL-073966/HL/NHLBI NIH HHS; HL-080093/HL/NHLBI NIH HHS; R01 HL073966/HL/NHLBI NIH HHS; R01 HL073966-04/HL/NHLBI NIH HHS; R01 HL080093/HL/NHLBI NIH HHS; R01 HL080093-03/HL/NHLBI NIH HHS; R01 HL080093-04/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
X4W3ENH1CV/Norepinephrine
Comments/Corrections

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