Abstract
The study introduces and validates a novel high-frequency (100–400 Hz bandwidth, 2 kHz sampling frequency) electrocardiographic imaging (HFECGI) technique that measures intramural ventricular electrical activation. Ex-vivo experiments and clinical measurements were employed. Ex-vivo, two pig hearts were suspended in a human-torso shaped tank using surface tank electrodes, epicardial electrode sock, and plunge electrodes. We compared conventional epicardial electrocardiographic imaging (ECGI) with intramural activation by HFECGI and verified with sock and plunge electrodes. Clinical importance of HFECGI measurements was performed on 14 patients with variable conduction abnormalities. From 3 × 4 needle and 108 sock electrodes, 256 torso or 184 body surface electrodes records, transmural activation times, sock epicardial activation times, ECGI-derived activation times, and high-frequency activation times were computed. The ex-vivo transmural measurements showed that HFECGI measures intramural electrical activation, and ECGI-HFECGI activation times differences indicate endo-to-epi or epi-to-endo conduction direction. HFECGI-derived volumetric dyssynchrony was significantly lower than epicardial ECGI dyssynchrony. HFECGI dyssynchrony was able to distinguish between intraventricular conduction disturbance and bundle branch block patients.
Highlights
The study introduces and validates a novel high-frequency (100–400 Hz bandwidth, 2 kHz sampling frequency) electrocardiographic imaging (HFECGI) technique that measures intramural ventricular electrical activation
Using the HF ECG technique, we showed that the ventricular electrical delay computed from V1–V6 lead signals of a cohort from MADIT-cardiac resynchronization therapy (CRT) trial could predict the probability of survival in CRT patients more effectively than standard ECG derived dyssynchrony p arameters[13]
The current study aims to compare the activation patterns of heart ventricles derived from the HF ECG imaging technique (HFECGI) with epicardial activation maps derived from conventional ECGI
Summary
The study introduces and validates a novel high-frequency (100–400 Hz bandwidth, 2 kHz sampling frequency) electrocardiographic imaging (HFECGI) technique that measures intramural ventricular electrical activation. We compared conventional epicardial electrocardiographic imaging (ECGI) with intramural activation by HFECGI and verified with sock and plunge electrodes. ECGI has been used for multiple analyses of ventricular activation and repolarization during normal synchronous activation, pacing, a rrhythmia[3,6], and for purposes of ventricular dyssynchrony a ssessment[7] With respect to the latter, ECGI was shown to improve the prediction of response to cardiac resynchronization therapy (CRT)[7,8,9,10]. HF and UHF ECG is currently being used in various clinical experiments to measure ventricular electrical activation, the validation of this technique was never performed. The current study aims to compare the activation patterns of heart ventricles derived from the HF ECG imaging technique (HFECGI) with epicardial activation maps derived from conventional ECGI
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