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Focal atrial tachycardia after pulmonary vein isolation: Noninvasive mapping with electrocardiographic imaging (ECGI)

2007; Elsevier BV; Volume: 4; Issue: 8 Linguagem: Inglês

10.1016/j.hrthm.2007.04.014

1556-3871

Yong Wang, Phillip S. Cuculich, Pamela K. Woodard, Bruce D. Lindsay, Yoram Rudy,

Cardiac pacing and defibrillation studies

Electrocardiographic imaging (ECGI) is a novel, noninvasive tool for imaging cardiac arrhythmia and defining electrophysiologic (EP) properties. 1 Ramanathan C. Ghanem R.N. Jia P. Ryu K. Rudy Y. Noninvasive electrocardiographic imaging for cardiac electrophysiology and arrhythmia. Nat Med. 2004; 10: 422-428 Crossref PubMed Scopus (511) Google Scholar , 2 Ramanathan C. Jia P. Ghanem R.N. Ryu K. Rudy Y. Activation and repolarization of the normal human heart under complete physiological conditions. Proc Nat Acad Sci U S A. 2006; 103: 6309-6314 Crossref PubMed Scopus (200) Google Scholar ECGI combines multielectrode body surface electrocardiogram (ECG) recordings with three-dimensional anatomical heart-torso imaging to reconstruct an epicardial electroanatomical map (Figure 1). ECGI-reconstructed data can be presented as epicardial potential maps, electrograms, or isochrones during activation and repolarization. The ECGI procedure has been extensively tested and validated in experimental preparations with normal and abnormal canine hearts. 3 Oster H.S. Taccardi B. Lux R.L. Ershler P.R. Rudy Y. Electrocardiographic imaging: noninvasive localization of pacing sites simulating ectopic foci. Circulation. 1994; 90: 1-437 Crossref PubMed Scopus (1) Google Scholar , 4 Oster H.S. Taccardi B. Lux R.L. Ershler P.R. Rudy Y. Noninvasive electrocardiographic imaging: reconstruction of epicardial potentials, electrograms, and isochrones and localization of single and multiple electrocardiac events. Circulation. 1997; 96: 1012-1024 Crossref PubMed Scopus (225) Google Scholar , 5 Oster H.S. Taccardi B. Lux R.L. Ershler P.R. Rudy Y. Electrocardiographic imaging: noninvasive characterization of intramural myocardial activation from inverse-reconstructed epicardial potentials and electrograms. Circulation. 1998; 97: 1496-1507 Crossref PubMed Scopus (132) Google Scholar , 6 Burnes J.E. Taccardi B. MacLeod R.S. Rudy Y. Noninvasive ECG imaging of electrophysiologically abnormal substrates in infarcted hearts: a model study. Circulation. 2000; 101: 533-540 Crossref PubMed Scopus (81) Google Scholar , 7 Burnes J.E. Taccardi B. Rudy Y. A noninvasive imaging modality for cardiac arrhythmias. Circulation. 2000; 102: 2152-2158 Crossref PubMed Scopus (109) Google Scholar , 8 Burnes J.E. Taccardi B. Ershler P.R. Rudy Y. Noninvasive electrocardiographic imaging of substrate and intramural ventricular tachycardia in infarcted hearts. J Am Coll Cardiol. 2001; 38: 2071-2078 Crossref PubMed Scopus (66) Google Scholar , 9 Burnes J.E. Ghanem R.N. Waldo A.L. Rudy Y. Imaging dispersion of myocardial repolarization I. Comparison of body-surface and epicardial measures. Circulation. 2001; 104: 1299-1305 Crossref PubMed Scopus (46) Google Scholar , 10 Ghanem R.N. Burnes J.E. Waldo A.L. Rudy Y. Imaging dispersion of myocardial repolarization II. Noninvasive reconstruction of epicardial measures. Circulation. 2001; 104: 1306-1312 Crossref PubMed Scopus (77) Google Scholar Recently, ECGI has been validated in humans. 1 Ramanathan C. Ghanem R.N. Jia P. Ryu K. Rudy Y. Noninvasive electrocardiographic imaging for cardiac electrophysiology and arrhythmia. Nat Med. 2004; 10: 422-428 Crossref PubMed Scopus (511) Google Scholar , 2 Ramanathan C. Jia P. Ghanem R.N. Ryu K. Rudy Y. Activation and repolarization of the normal human heart under complete physiological conditions. Proc Nat Acad Sci U S A. 2006; 103: 6309-6314 Crossref PubMed Scopus (200) Google Scholar , 11 Jia P. Ramanathan C. Ghanem R.N. Ryu K. Varma N. Rudy Y. Electrocardiographic imaging of cardiac resynchronization therapy in heart failure: observation of variable electrophysiologic responses. Heart Rhythm. 2006; 3: 296-310 Abstract Full Text Full Text PDF PubMed Scopus (152) Google Scholar , 12 Intini A. Goldstein R.N. Jia P. Ramanathan C. Ryu K. Giannattasio B. Gilkeson R. Stambler B.S. Brugada P. Stevenson W.G. Rudy Y. Waldo A.L. Electrocardiographic imaging (ECGI), a novel diagnostic modality used for mapping of focal left ventricular tachycardia in a young athlete. Heart Rhythm. 2005; 2: 1250-1252 Abstract Full Text Full Text PDF PubMed Scopus (68) Google Scholar , 13 Ghanem R.N. Jia P. Ramanathan C. Ryu K. Markowitz A. Rudy Y. Noninvasive electrocardiographic imaging (ECGI): comparison to intraoperative mapping in patients. Heart Rhythm. 2005; 2: 339-354 Abstract Full Text Full Text PDF PubMed Scopus (125) Google Scholar To date, we have presented human ECGI studies of normal activation and repolarization, 1 Ramanathan C. Ghanem R.N. Jia P. Ryu K. Rudy Y. Noninvasive electrocardiographic imaging for cardiac electrophysiology and arrhythmia. Nat Med. 2004; 10: 422-428 Crossref PubMed Scopus (511) Google Scholar , 2 Ramanathan C. Jia P. Ghanem R.N. Ryu K. Rudy Y. Activation and repolarization of the normal human heart under complete physiological conditions. Proc Nat Acad Sci U S A. 2006; 103: 6309-6314 Crossref PubMed Scopus (200) Google Scholar right and left bundle branch block, 1 Ramanathan C. Ghanem R.N. Jia P. Ryu K. Rudy Y. Noninvasive electrocardiographic imaging for cardiac electrophysiology and arrhythmia. Nat Med. 2004; 10: 422-428 Crossref PubMed Scopus (511) Google Scholar , 11 Jia P. Ramanathan C. Ghanem R.N. Ryu K. Varma N. Rudy Y. Electrocardiographic imaging of cardiac resynchronization therapy in heart failure: observation of variable electrophysiologic responses. Heart Rhythm. 2006; 3: 296-310 Abstract Full Text Full Text PDF PubMed Scopus (152) Google Scholar various pacing protocols, 1 Ramanathan C. Ghanem R.N. Jia P. Ryu K. Rudy Y. Noninvasive electrocardiographic imaging for cardiac electrophysiology and arrhythmia. Nat Med. 2004; 10: 422-428 Crossref PubMed Scopus (511) Google Scholar , 11 Jia P. Ramanathan C. Ghanem R.N. Ryu K. Varma N. Rudy Y. Electrocardiographic imaging of cardiac resynchronization therapy in heart failure: observation of variable electrophysiologic responses. Heart Rhythm. 2006; 3: 296-310 Abstract Full Text Full Text PDF PubMed Scopus (152) Google Scholar , 13 Ghanem R.N. Jia P. Ramanathan C. Ryu K. Markowitz A. Rudy Y. Noninvasive electrocardiographic imaging (ECGI): comparison to intraoperative mapping in patients. Heart Rhythm. 2005; 2: 339-354 Abstract Full Text Full Text PDF PubMed Scopus (125) Google Scholar atrial flutter, 1 Ramanathan C. Ghanem R.N. Jia P. Ryu K. Rudy Y. Noninvasive electrocardiographic imaging for cardiac electrophysiology and arrhythmia. Nat Med. 2004; 10: 422-428 Crossref PubMed Scopus (511) Google Scholar native sinus rhythm and biventricular pacing for cardiac resynchronization in heart failure patients, 11 Jia P. Ramanathan C. Ghanem R.N. Ryu K. Varma N. Rudy Y. Electrocardiographic imaging of cardiac resynchronization therapy in heart failure: observation of variable electrophysiologic responses. Heart Rhythm. 2006; 3: 296-310 Abstract Full Text Full Text PDF PubMed Scopus (152) Google Scholar and focal ventricular tachycardia. 12 Intini A. Goldstein R.N. Jia P. Ramanathan C. Ryu K. Giannattasio B. Gilkeson R. Stambler B.S. Brugada P. Stevenson W.G. Rudy Y. Waldo A.L. Electrocardiographic imaging (ECGI), a novel diagnostic modality used for mapping of focal left ventricular tachycardia in a young athlete. Heart Rhythm. 2005; 2: 1250-1252 Abstract Full Text Full Text PDF PubMed Scopus (68) Google Scholar