Noninvasive imaging of cardiac electrophysiology

Abstract

Noninvasive imaging of cardiac electrophysiology is still a major goal despite all recent technical innovations. This review gives an overview about the historical background, recent developments and possible future applications of noninvasive imaging of cardiac electrophysiology.

Figure 1

The left panel shows a MRI cardiac short axis scan (slice thickness 6mm). The middle panel shows a triangulated and remeshed surface model of individual cardiac anatomy (LV=left ventricle; RV=right ventricle; RVOT=right ventricular outflow tract). The right panel shows the fusion of MRI data and the individual cardiac model. (Figure modified from Berger T et al, Single-beat noninvasive imaging of cardiac electrophysiology of ventricular pre-excitation. J Am Coll Cardiol 2006; 48: 2045-52. with permission. Copyright Elsevier, American College of Cardiology, 2006)

Figure 2

Localization of the 65-leads on the chest surface as used for the NICE approach. (Figure modified from Berger T et al, Single-beat noninvasive imaging of cardiac electrophysiology of ventricular pre-excitation. J Am Coll Cardiol 2006; 48: 2045-52. with permission. Copyright Elsevier, American College of Cardiology, 2006)

Figure 3

Workflow of NICE

Figure 4

The areas of first onset of ventricular activation are indicated by red colour, the areas of latest activation are indicated by blue colour, as obtained by NICE. Here, preexcitation is indicated by early ventricular activation (red area) in a patient with a left posterolateral accessory pathway. The ablation points (grey markers) and the location of successful ablation (purple marker) indicating the ventricular insertion site of the accessory pathway, as obtained by CARTO™. Head icons indicate point of view. Isochrones are plotted in 20 ms intervals. (Figure modified from Berger T et al, Single-beat noninvasive imaging of cardiac electrophysiology of ventricular pre-excitation. J Am Coll Cardiol 2006; 48: 2045-52. with permission. Copyright Elsevier, American College of Cardiology, 2006)