The relationship of myocardial contraction and electrical excitation--the correlation between scintigraphic phase image analysis and electrophysiologic mapping.
BACKGROUND
Phase imaging derived from equilibrium radionuclide angiography presents the ventricular contraction sequence. It has been widely but only indirectly correlated with the sequence of electrical myocardial activation.


OBJECTIVE
We sought to determine the specific relationship between the sequence of phase progression and the sequence of myocardial activation, contraction and conduction, in order to document a noninvasive method that could monitor both.


METHODS
In 7 normal and 9 infarcted dogs, the sequence of phase angle was correlated with the epicardial activation map in 126 episodes of sinus rhythm and pacing from three ventricular sites.


RESULTS
In each episode, the site of earliest phase angle was identical to the focus of initial epicardial activation. Similarly, the serial contraction pattern by phase image analysis matched the electrical epicardial activation sequence completely or demonstrated good agreement in approximately 85% of pacing episodes, without differences between normal or infarct groups.


CONCLUSIONS
A noninvasive method to accurately determine the sequence of contraction may serve as a surrogate for the associated electrical activation sequence or be applied to identify their differences.
del Romeral
L Munoz
LM
Division of Heart Failure and Pulmonary Hypertension, Alta Bates Hospital, Berkeley, CA, USA.
Stillson
C
C
Lesh
M
M
Dae
M
M
Botvinick
Elias
E
D000200:Action Potentials / Q000502:physiology*; D000818:Animals; D018780:Body Surface Potential Mapping / Q000379:methods*; D004285:Dogs; D006329:Heart Conduction System / Q000000981:diagnostic imaging* / Q000502:physiology*; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D009200:Myocardial Contraction / Q000502:physiology*; D011877:Radionuclide Imaging; D013223:Statistics as Topic; D016277:Ventricular Function, Left / Q000502:physiology*