Novel non-invasive ECG imaging method based on the 12-lead ECG for reconstruction of ventricular activation: A proof-of-concept study

Frontiers in Cardiovascular Medicine

Cardiovascular Medicine

Anders Sommer¹  Tomas Zaremba¹  Patricia Zerlang Fruelund²  Peter Søgaard²  Sam Riahi²  Peter M. Van Dam³  Jacob Melgaard⁴  Claus Graff⁴  Søren Lundbye-Christensen⁵ 

[1] Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark;Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark;Department of Clinical Medicine, Aalborg University, Aalborg, Denmark;Department of Cardiology, University Medical Center Utrecht, Utrecht, Netherlands;Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark;Unit of Clinical Biostatistics, Aalborg University Hospital, Aalborg, Denmark;

关键词: electrocardiography;    non-invasive imaging;    cardiac pacing;    ventricular activation;    patient-specific modeling;    12-lead electrocardiogram;   

DOI  :  10.3389/fcvm.2023.1087568

 received in 2022-11-02, accepted in 2023-01-18,  发布年份 2023

来源: Frontiers

【 摘 要 】

AimCurrent non-invasive electrocardiographic imaging (ECGi) methods are often based on complex body surface potential mapping, limiting the clinical applicability. The aim of this pilot study was to evaluate the ability of a novel non-invasive ECGi method, based on the standard 12-lead ECG, to localize initial site of ventricular activation in right ventricular (RV) paced patients. Validation of the method was performed by comparing the ECGi reconstructed earliest site of activation against the true RV pacing site determined from cardiac computed tomography (CT).MethodsThis was a retrospective study using data from 34 patients, previously implanted with a dual chamber pacemaker due to advanced atrioventricular block. True RV lead position was determined from analysis of a post-implant cardiac CT scan. The ECGi method was based on an inverse-ECG algorithm applying electrophysiological rules. The algorithm integrated information from an RV paced 12-lead ECG together with a CT-derived patient-specific heart-thorax geometric model to reconstruct a 3D electrical ventricular activation map.ResultsThe mean geodesic localization error (LE) between the ECGi reconstructed initial site of activation and the RV lead insertion site determined from CT was 13.9 ± 5.6 mm. The mean RV endocardial surface area was 146.0 ± 30.0 cm2 and the mean circular LE area was 7.0 ± 5.2 cm2 resulting in a relative LE of 5.0 ± 4.0%.ConclusionWe demonstrated a novel non-invasive ECGi method, based on the 12-lead ECG, that accurately localized the RV pacing site in relation to the ventricular anatomy.

【 授权许可】

Unknown   
Copyright © 2023 Fruelund, Van Dam, Melgaard, Sommer, Lundbye-Christensen, Søgaard, Zaremba, Graff and Riahi.