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Usefulness of body surface maps to demonstrate ventricular activation patterns during left ventricular pacing and reentrant activation during ventricular tachycardia in men with coronary heart disease and left ventricular dysfunction

Biomedical Sciences Research Institute Computer Science Research Institute Environmental Sciences Research Institute Nanotechnology & Advanced Materials Research Institute

McClelland, AJJ, Owens, CG, Navarro, C, Smith, B, Roberts, MJD, Anderson, JMCC and Adgey, AAJ (2006) Usefulness of body surface maps to demonstrate ventricular activation patterns during left ventricular pacing and reentrant activation during ventricular tachycardia in men with coronary heart disease and left ventricular dysfunction. The American Journal of Cardiology, 98 (5). pp. 591-596. [Journal article]

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Abstract

Epicardial electrical events were reconstructed using an inverse model for left ventricular (LV) pacing and during ventricular tachycardia (VT) induced during implantation of a biventricular pacemaker and/or internal defibrillator. The electrocardiographic position of the pacing lead, determined from the region of most negative potential 30 ms after the pacing spike, was compared with the radiographic position. Activation characterized by isochronal maps was correlated with the echocardiographic/myocardial scintigraphic data. Reconstructed epicardial isopotential/isochronal maps during VT were used to determine the presence of reentry. In 7 patients during LV pacing, epicardial isopotential maps located the maximum negative potentials anterolaterally (n = 3), posterolaterally (n = 2), and posteriorly (n = 2). Isochronal maps demonstrated activation patterns including regions of delayed activation that, in 5 patients, correlated with areas of akinesia/hypokinesia or fixed defects on echocardiography/myocardial scintigraphy. The mean difference between the radiographically measured right ventricular to LV pacing lead distance and calculated electrocardiographic right ventricular to LV pacing site distance was 1.7 cm. During VT, induced in 5 patients, single-loop reentry was observed in 3 and figure-of-8 reentry in 2. Exit site and regions of fast/slow conduction and conduction block that correlated with anatomic areas of infarction defined by echocardiography/myocardial scintigraphy were demonstrated. In conclusion, epicardial maps reconstructed from the body surface map can identify LV pacing sites and demonstrate reentry during VT. The body surface map could thus identify optimal pacing sites for LV pacing and targets for VT ablation.

Item Type:Journal article
Keywords:Aged; Body Surface Potential Mapping; Cardiac Pacing, Artificial: methods; Coronary Disease: complications; Coronary Disease: physiopathology; Follow-Up Studies; Humans; Image Processing, Computer-Assisted; Male; Middle Aged; Reproducibility of Results; Tachycardia, Ventricular: complications; Tachycardia, Ventricular: physiopathology; Tachycardia, Ventricular: therapy; Ventricular Dysfunction, Left: complications; Ventricular Dysfunction, Left: physiopathology
Faculties and Schools:Faculty of Computing & Engineering
Faculty of Computing & Engineering > School of Engineering
ID Code:19135
Deposited By:Mrs Ann Blair
Deposited On:29 Jul 2011 13:29
Last Modified:29 Jul 2011 13:29

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