Document Detail

Noninvasive electrocardiogram imaging of substrate and intramural ventricular tachycardia in infarcted hearts.
MedLine Citation:
PMID:  11738317     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The goal of this study was to experimentally evaluate a novel noninvasive electrocardiographic imaging modality during intramural reentrant ventricular tachycardia (VT).
BACKGROUND: Myocardial infarction and subsequent remodeling produce abnormal electrophysiologic substrates capable of initiating and maintaining reentrant arrhythmias. Existing noninvasive electrocardiographic methods cannot characterize abnormal electrophysiologic substrates in the heart or the details of associated arrhythmias. A noninvasive method with such capabilities is needed to identify patients at risk of arrhythmias and to guide and evaluate therapy.
METHODS: A dog heart with a four-day-old infarction was suspended in a human shaped torso-tank. Measured body surface potentials were used to noninvasively compute epicardial potentials, electrograms and isochrones. Accuracy of reconstruction was evaluated by direct comparison to measured data. Reconstructions were performed during right atrial pacing and nine cycles of VT.
RESULTS: Noninvasively reconstructed potential maps, electrograms and isochrones identified: 1) the location of electrophysiologically abnormal infarct substrate; 2) the epicardial activation sequences during the VTs; 3) the locations of epicardial breakthrough sites; and 4) electrophysiologic evidence for activation of the Purkinje system and septum during the reentrant beats.
CONCLUSIONS: Electrocardiographic imaging can noninvasively reconstruct electrophysiologic information on the epicardium during VT with intramural reentry, provide information about the location of the intramural components of reentry and image abnormal electrophysiologic substrates associated with infarction.
J E Burnes; B Taccardi; P R Ershler; Y Rudy
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  38     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2001 Dec 
Date Detail:
Created Date:  2001-12-12     Completed Date:  2002-01-02     Revised Date:  2011-01-10    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2071-8     Citation Subset:  AIM; IM    
Cardiac Bioelectricity Research and Training Center (CBRTC) and the Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio 44106-7207, USA.
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MeSH Terms
Body Surface Potential Mapping*
Cardiac Pacing, Artificial
Imaging, Three-Dimensional*
Models, Cardiovascular
Myocardial Infarction / pathology,  physiopathology*
Pericardium / pathology,  physiopathology
Purkinje Fibers / pathology,  physiopathology
Tachycardia, Ventricular / pathology,  physiopathology*
Grant Support
Comment In:
J Am Coll Cardiol. 2002 May 15;39(10):1710-1   [PMID:  12020513 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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