NONINVASIVE ECG IMAGING VISUALISES ROTORS AND MULTIPLE WAVELETS IN PATIENTS WITH VENTRICULAR FIBRILLATION
E. Fetisova, A. Tsyganov, E. Wissner, M. Chaikovskaya, M. Chmelevsky, S. Deiss, T. Maurer, M. Yakovleva, K.H. Kuck
1. Petrovsky National Research Centre of Surgery, Moscow, Russian Federation; 2. Asklepios Klinik St. Georg, Hamburg, Germany; 3. North-West Federal Medical Research Centre, Saint Petersburg, Russian Federation
Introduction: The goal of this study was to map the activation patterns of ventricular arrhythmias using noninvasive ECG imaging (ECGI).
Methods: In 15 patients undergoing invasive electrophysiology study, ventricular arrhythmias were induced in 8 patients (4 ischemic and 4 nonischemic). ECGI system was used for mapping of VF/PMVT (EP Solutions SA, Switzerland). Total 224 electrodes were applied to the patient’s torso. Pre-procedural CT imaging was performed for each patient in order to determine cardiac anatomy and body surface electrode positions. This was followed by epicardial/endocardial surface rendering of both ventricles. During tachycardia the surface ECG were recorded and approximately 5000 local unipolar EG on the epicardium/endocardium were reconstructed. The phase of the unipolar EG at each point was calculated using the Hilbert transform and a phase map was built.
Results: In some cases, VF/PMVT was driven by a single reentrant wave roving through the epicardium for several cycles; in other cases the dominant migrating rotor divided into several wavelets (Figure).
Conclusions: ECGI of VF/PMVT demonstrates that rotors and multiple wavelets can coexist.
Figure 1.
