[Research Articles] Noninvasive localization of cardiac arrhythmias using electromechanical wave imaging

This study evaluates the accuracy of EWI for localization of various arrhythmias in all four chambers of the heart before catheter ablation. Fifty-five patients with an accessory pathway (AP) with Wolff-Parkinson-White (WPW) syndrome, premature ventricular complexes (PVCs), atrial tachycardia (AT), or atrial flutter (AFL) underwent transthoracic EWI and 12-lead ECG. Three-dimensional (3D) rendered EWI isochrones and 12-lead ECG predictions by six electrophysiologists were applied to a standardized segmented cardiac model and subsequently compared to the region of successful ablation on 3D electroanatomical maps generated by invasive catheter mapping. There was significant interobserver variability among 12-lead ECG reads by expert electrophysiologists. EWI correctly predicted 96% of arrhythmia locations as compared with 71% for 12-lead ECG analyses [unadjusted for arrhythmia type: odds ratio (OR), 11.8; 95% confidence interval (CI), 2.2 to 63.2; P = 0.004; adjusted for arrhythmia type: OR, 12.1; 95% CI, 2.3 to 63.2; P = 0.003]. This double-blinded clinical study demonstrates that EWI can localize atrial and ventricular arrhythmias including WPW, PVC, AT, and AFL. EWI when used with ECG may allow for improved treatment for patients with arrhythmias.

Source: Science Translational Medicine - March 24, 2020 Category: Biomedical Science Authors: Grubb, C. S., Melki, L., Wang, D. Y., Peacock, J., Dizon, J., Iyer, V., Sorbera, C., Biviano, A., Rubin, D. A., Morrow, J. P., Saluja, D., Tieu, A., Nauleau, P., Weber, R., Chaudhary, S., Khurram, I., Waase, M., Garan, H., Konofagou, E. E., Wan, E. Y. Tags: Research Articles Source Type: research