Atrial noninvasive activation mapping of paced rhythm data.
BACKGROUND
Atrial arrhythmias have emerged as a topic of great interest for clinical electrophysiologists. Noninvasive imaging of electrical function in humans may be useful for computer-aided diagnosis and treatment of cardiac arrhythmias, which can be accomplished by the fusion of data from ECG mapping and magnetic resonance imaging (MRI).


RESULTS
In this study, a bidomain-theory-based surface heart model activation time (AT) imaging approach was applied to paced rhythm data from four patients. Pacing sites were the right superior pulmonary vein, left inferior pulmonary vein, left superior pulmonary vein, coronary sinus, posterior wall of right atrium, and high right atrium. For coronary sinus pacing, the AT pattern of the right atrium was compared with a CARTO map. The root mean square error between CARTO geometry (85 nodal points) and the surface model of the right atrium was 8.6 mm. The correlation coefficient of the noninvasively obtained AT map of the right atrium and the CARTO map was 0.76. All pulmonary vein pacing sites were identified. The reconstructed pacing site of right posterior atrial pacing correlates with the invasively determined pacing catheter position with a localization distance of 4 mm.


CONCLUSIONS
The individual anatomic model of the atria of each patient enables accurate noninvasive AT imaging within the atria, resulting in a localization error for the pacing sites within 10 mm. Our findings may have implications for imaging of atrial activity in patients with focal arrhythmias or focal triggers.
Modre
Robert
R
Institute for Medical Signal Processing and Imaging, University for Health Informatics and Technology Tyrol, Innrain 98, 6020 Innsbruck, Austria. robert.modre@umit.at
Tilg
Bernhard
B
Fischer
Gerald
G
Hanser
Friedrich
F
Messnarz
Bernd
B
Seger
Michael
M
Schocke
Michael F H
MF
Berger
Thomas
T
Hintringer
Florian
F
Roithinger
Franz X
FX
D000328:Adult; D001281:Atrial Fibrillation / Q000503:physiopathology*; D018780:Body Surface Potential Mapping / Q000379:methods*; D002304:Cardiac Pacing, Artificial; D003198:Computer Simulation; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000503:physiopathology*; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D008959:Models, Neurological