Real-Time Localization of Ventricular Tachycardia Origin From the 12-Lead Electrocardiogram

JACC. Clinical Electrophysiology
John L SappB Milan Horáček

Abstract

The aim of this study was to develop rapid computational methods for identifying the site of origin of ventricular activation from the 12-lead electrocardiogram. Catheter ablation of ventricular tachycardia in patients with structural heart disease frequently relies on a substrate-based approach, which may use pace mapping guided by body-surface electrocardiography to identify culprit exit sites. Patients undergoing ablation of scar-related VT (n = 38) had 12-lead electrocardiograms recorded during pacing at left ventricular endocardial sites (n = 1,012) identified on 3-dimensional electroanatomic maps and registered to a generic left ventricular endocardial surface divided into 16 segments and tessellated into 238 triangles; electrocardiographic data were reduced for each lead to 1 variable, consisting of QRS time integral. Two methods for estimating the origin of activation were developed: 1) a discrete method, estimating segment of activation origin using template matching; and 2) a continuous method, using population-based multiple linear regression to estimate triangle of activation origin. A variant of the latter method was derived, using patient-specific multiple linear regression. The optimal QRS time integral included ...Continue Reading

References

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Citations

May 11, 2019·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Edmond M CroninUNKNOWN ESC Scientific Document Group
Aug 29, 2019·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Wener LvRichard J Cohen
Jan 28, 2020·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Edmond M CroninKatja Zeppenfeld
Feb 19, 2020·Circulation. Arrhythmia and Electrophysiology·John L SappLinwei Wang
Feb 3, 2021·Pacing and Clinical Electrophysiology : PACE·Shijie ZhouNatalia A Trayanova
Feb 19, 2021·Circulation Research·Natalia A TrayanovaJulie K Shade
Jun 15, 2021·Computer Methods in Biomechanics and Biomedical Engineering·Nevena RadovićTanja Antunović
Oct 7, 2021·Journal of the American Heart Association·Shijie ZhouJonathan Chrispin

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