Abstract 12106: Electrocardiographic Imaging Accuracy and Coherence Between Two Different Systems

Abstract

Introduction: Previous studies reporting on electrocardiographic imaging (ECGI), using an epicardial-only system, have suggested a bad accuracy Hypothesis: Assess the accuracy and coherence of two endo-epicardial ECGI systems using different cardiac sources. Methods: We performed 61 ECGI procedures in 48 patients referred for ablation of frequent idiopathic premature ventricular contractions (PVCs) at our center. The Amycard (EP Solutions SA, Switzerland) system based on the extracellular potential, was used in 26 patients, the VIVO (Catheter Precision, NJ USA) systems based on the equivalent double layer model in 9, and both in 13 patients. The localisation of the PVCs based on ECGI was done using a segmental model with 22 segments on the left ventricle, to include the classical 17 segment model plus the aortic cusps and the papillary muscles, and 12 segments on the right ventricle including 4 on the right ventricular outflow tract (RVOT). A perfect match (PM) was defined as a predicted location within the same anatomic segment, whereas a near match (NM) as a predicted location within the same segment or a contiguous one. Results: Ablation was performed in 42 patients, successful in 76%. The origin of the PVCs was the RVOT in 22 patients, right ventricle in 5, coronary cusps in 3, left ventricle in 3, LV summit in 3, LVOT in 2, papillary muscles in 2, moderator band in 1 and aortomitral continuity in 1. The agreement between the predicted site and the invasive mapping with both systems is depicted in the table. The percentage of PM and NM was not significantly different. In the 13 patients that had the ECGI performed with both systems, we found a NM in 100% and a PM in 70%. (Figure). Conclusions: ECGI is an accurate diagnostic tool with reproducible results regardless the cardiac source used for analysis.