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Single-Beat Noninvasive Imaging of Cardiac Electrophysiology of Ventricular Pre-Excitation
Open accessAbstract
Objectives The aim of this study was to determine whether noninvasive imaging of cardiac electrophysiology (NICE) is feasible in patients with Wolff-Parkinson-White (WPW) syndrome in the clinical setting of a catheter laboratory and to test the accuracy of the noninvasively obtained ventricular activation sequences as compared with that of standard invasive electroanatomic mapping.Background NICE of ventricular activation could serve as a useful tool in the treatment of cardiac arrhythmias and might help improve our understanding of arrhythmia mechanisms.Methods NICE works by fusing the data from high-resolution electrocardiographic mapping and a model of the patient's cardiac anatomy obtained by magnetic resonance imaging. The ventricular activation sequence was computed with a bidomain theory-based heart model to solve this inverse problem. Noninvasive imaging of cardiac electrophysiology was performed in 7 patients with WPW syndrome undergoing catheter ablation of the accessory pathway. The position error of NICE was defined as the distance between the site of earliest activation computed by NICE and the successful ablation site identified by electroanatomic mapping (CARTO; Biosense Webster, Diamond Bar, California) for normal atrioventricular (AV) conduction as well as for adenosine-induced AV block.Results The error introduced by geometric coupling of the CARTO data and the NICE model was 5 +/- 3 mm (model discretization 10 mm). All ventricular accessory pathway insertion sites were identified with an accuracy of 18.7 +/- 5.8 mm (baseline) and 18.7 +/- 6.4 mm (adenosine).Conclusions The individual cardiac anatomy model obtained for each patient enables accurate noninvasive electrocardiographic imaging of ventricular pre-excitation in patients with WPW syndrome. Noninvasive imaging of cardiac electrophysiology might be used as a complementary noninvasive approach to localize the origin and help identify and understand the underlying mechanisms of cardiac arrhythmias.
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BSPM has nowadays got a real clinical breakthrough as a method for non-invasive 3D EAI, with the competitive concept of ECG imaging (ECGi), a technology that has rapidly evolved in clinically available devices, increasingly used for non-invasive pre-interventional assessment of patients undergoing catheter ablation procedures.
“BSPM has nowadays got a real clinical breakthrough as a method for non-invasive 3D EAI, with the competitive concept of “ECG imaging” (ECGi) (239–241), a technology that has rapidly evolved in clinically available devices (242), increasingly used for non-invasive pre-interventional assessment of patients undergoing catheter ablation procedures (243, 244).”
From Clinical magnetocardiography: the unshielded bet—past, present, and future (2023) · cites this paper as [240]
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Metadata
- Authors
- Berger, T., Fischer, G., Pfeifer, B., Modre, R., Hanser, F., Trieb, T., Roithinger, F. X., Stuehlinger, M., Pachinger, O., Tilg, B., & Hintringer, F.
- Affiliations
- Innsbruck Medical University (AT)
- UMIT TIROL - Private University for Health Sciences and Health Technology (AT)
- Corresponding author
- Berger, Thomas
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2006-11
- Volume
- 48
- Issue
- 10
- Pages
- 2045-2052
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2062081311
- Cited by
- 107
- References
- 17
- Citations by year
- 2026: 1 · 2025: 7 · 2024: 2 · 2023: 2 · 2021: 1 · 2020: 6 · 2019: 5 · 2018: 5 · 2017: 4 · 2016: 10 · 2015: 11 · 2014: 6 · 2013: 6 · 2012: 9
- FWCI
- 3.32
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Austrian Science Fund
- Oesterreichische Nationalbank
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Keywords
- Wolff-Parkinson-White syndrome, preexcitation, accessory pathway localization, electroanatomical mapping, bidomain model, inverse problems, catheter ablation, cardiac arrhythmia mechanisms
- MeSH terms
- Adult, Electrodiagnosis, Electroencephalography, Feasibility Studies, Female, Humans, Magnetic Resonance Imaging, Male, Models, Cardiovascular, Wolff-Parkinson-White Syndrome, Catheter Ablation
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