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Review
. 2017 Jun 15:237:13-14.
doi: 10.1016/j.ijcard.2017.02.104. Epub 2017 Feb 27.

Noninvasive ECG imaging (ECGI): Mapping the arrhythmic substrate of the human heart

Yoram Rudy  1
Affiliations
Review

Noninvasive ECG imaging (ECGI): Mapping the arrhythmic substrate of the human heart

Yoram Rudy. Int J Cardiol. .

Abstract

This short communication accompanies my presentation at the International Congress on Sudden Cardiac Death held in Prague, March 30-April 1, 2017. It summarizes briefly studies of the cardiac electrophysiological substrate in patients with hereditary arrhythmogenic syndromes - the Long QT and Brugada syndromes - conducted noninvasively, in situ, using Electrocardiographic Imaging (ECGI). The same noninvasive approach was used to map the electrophysiological substrate of a post-infarction myocardial scar and to relate this substrate to the pattern of activation during reentrant ventricular tachycardia. My thoughts about a potential role for ECGI in cardiac research and clinical care are also expressed briefly, with examples from on-going work in my laboratory.

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Conflict of interest statement

Conflict of Interest: Yoram Rudy receives royalties from CardioInsight Technologies (CIT). CIT does not support any research conducted in Dr. Rudy’s laboratory.

Figures

Figure 1
Figure 1
The ECGI procedure. Body surface potentials are recorded from 256 electrodes. Patient-specific heart-torso geometry is obtained from thoracic CT or MRI scan. The data are combined using mathematical algorithms to reconstruct epicardial potentials and unipolar electrograms on the heart surface. Maps of epicardial activation and recovery can be further derived from the electrograms.
See this image and copyright information in PMC

References

    1. Ramanathan C, Ghanem RN, Jia P, Ryu K, Rudy Y. Electrocardiographic Imaging (ECGI): A Noninvasive Imaging Modality for Cardiac Electrophysiology and Arrhythmia. Nature Medicine. 2004;10:422–428. - PMC - PubMed
    1. Ramanathan C, Jia P, Ghanem RN, Ryu K, Rudy Y. Activation and repolarization of the normal human heart under complete physiological conditions. Proc Natl Acad Sci USA (PNAS) 2006;103:6309–14. - PMC - PubMed
    1. Vijayakumar Ramya, Silva Jennifer NA, Desouza Kavit A, Abraham Robert L, Strom Maria, Sacher Frederic, Van Hare George F, Haïssaguerre Michel, Roden Dan M, Rudy Yoram. Electrophysiologic Substrate in Congenital Long QT Syndrome: Noninvasive Mapping with Electrocardiographic Imaging (ECGI) Circulation. 2014;130:1936–1943. - PMC - PubMed
    1. Zhang J, Sacher F, Hoffmayer K, O’Hara T, Strom M, Cuculich P, Silva J, Cooper D, Faddis M, Hocini M, Haissaguerre M, Scheinman M, Rudy Y. The Cardiac Electrophysiologic Substrate Underlying the ECG Phenotype and Electrogram Abnormalities in Brugada Syndrome Patients. Circulation. 2015;131:1950–1959. - PMC - PubMed
    1. Cuculich PS, Zhang J, Wang Y, Desouza KA, Vijayakumar R, Woodard PK, Rudy Y. The Electrophysiologic Cardiac Ventricular Substrate in Patients after Myocardial Infarction: Noninvasive Characterization with ECG Imaging (ECGI) J Am Col Cardiol (JACC) 2011;58:1893–1902. - PMC - PubMed

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