title: Validation of the mapping accuracy of a novel non-invasive epicardial and endocardial electrophysiology system.
abstract: OBJECTIVE
  Use of a non-invasive electrocardiographic mapping system may aid in rapid diagnosis of atrial or ventricular arrhythmias or the detection of ventricular dyssynchrony. The aim of the present study was to validate the mapping accuracy of a novel non-invasive epi- and endocardial electrophysiology system (NEEES).
  
  
  RESULTS
  Patients underwent pre-procedural computed tomography or magnetic resonance imaging of the heart and torso. Radiographic data were merged with the data obtained from the NEEES during pacing from implanted pacemaker leads or pacing from endocardial sites using an electroanatomical mapping system (CARTO 3, Biosense Webster). The earliest activation as denoted on the NEEES three-dimensional heart model was compared with the true anatomic location of the tip of the pacemaker lead or the annotated pacing site on the CARTO 3 map. Twenty-nine patients [mean age: 62 ± 11 years, 6/29 (11%) female, 21/29 (72%) with ischaemic cardiomyopathy] were enrolled into the pacemaker verification group. The mean distance from the non-invasively predicted pacing site to the anatomic reference site was 10.8 ± 5.4 mm for the right atrium, 7.7 ± 5.8 mm for the right ventricle, and 7.9 ± 5.7 mm for the left ventricle activated via the coronary sinus lead. Five patients [mean age 65 ± 4 years, 2 (33%) females] underwent CARTO 3 verification study. The mean distance between non-invasively reconstructed pacing site and the reference pacing site was 7.4 ± 2.7 mm for the right atrium, 6.9 ± 2.3 mm for the left atrium, 6.5 ± 2.1 mm for the right ventricle, and 6.4 ± 2.2 for the left ventricle, respectively.
  
  
  CONCLUSIONS
  The novel NEEES was able to correctly identify the site of pacing from various endo- and epicardial sites with high accuracy.
authors: Bakoulev Scientific Center for Cardiovascular Surgery of the Russian Academy of Science, Moscow, Russia.
authors: Amiran S
authors: AS
authors: Revishvili
authors: Stereotaxis Laboratory, Asklepios Klinik St Georg, II. Medizinische Abteilung, Lohmühlenstraße 5, Hamburg 20099, Germany e.wissner@asklepios.com.
authors: Erik
authors: E
authors: Wissner
authors: Federal Almazov Medical Research Center, St Petersburg, Russia.
authors: Dmitry S
authors: DS
authors: Lebedev
authors: Stereotaxis Laboratory, Asklepios Klinik St Georg, II. Medizinische Abteilung, Lohmühlenstraße 5, Hamburg 20099, Germany.
authors: Christine
authors: C
authors: Lemes
authors: Stereotaxis Laboratory, Asklepios Klinik St Georg, II. Medizinische Abteilung, Lohmühlenstraße 5, Hamburg 20099, Germany.
authors: Sebastian
authors: S
authors: Deiss
authors: Stereotaxis Laboratory, Asklepios Klinik St Georg, II. Medizinische Abteilung, Lohmühlenstraße 5, Hamburg 20099, Germany.
authors: Andreaas
authors: A
authors: Metzner
authors: Bakoulev Scientific Center for Cardiovascular Surgery of the Russian Academy of Science, Moscow, Russia.
authors: Vitaly V
authors: VV
authors: Kalinin
authors: Bakoulev Scientific Center for Cardiovascular Surgery of the Russian Academy of Science, Moscow, Russia.
authors: Oleg V
authors: OV
authors: Sopov
authors: Bakoulev Scientific Center for Cardiovascular Surgery of the Russian Academy of Science, Moscow, Russia.
authors: Eugeny Z
authors: EZ
authors: Labartkava
authors: Institute for Information Transmission Problems of the Russian Academy of Science, Moscow, Russia.
authors: Alexander V
authors: AV
authors: Kalinin
authors: Federal Almazov Medical Research Center, St Petersburg, Russia.
authors: Michail
authors: M
authors: Chmelevsky
authors: Federal Almazov Medical Research Center, St Petersburg, Russia.
authors: Stephan V
authors: SV
authors: Zubarev
authors: EP Solutions SA, Yverdon-les-Bains, Switzerland.
authors: Maria K
authors: MK
authors: Chaykovskaya
authors: EP Solutions SA, Yverdon-les-Bains, Switzerland.
authors: Mikhail G
authors: MG
authors: Tsiklauri
authors: Stereotaxis Laboratory, Asklepios Klinik St Georg, II. Medizinische Abteilung, Lohmühlenstraße 5, Hamburg 20099, Germany.
authors: Karl-Heinz
authors: KH
authors: Kuck
mesh_terms: D018780:Body Surface Potential Mapping / Q000295:instrumentation*; D002304:Cardiac Pacing, Artificial; D004699:Endocardium; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D008875:Middle Aged; D010496:Pericardium; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D017180:Tachycardia, Ventricular / Q000175:diagnosis* / Q000517:prevention & control*; D014693:Ventricular Fibrillation / Q000175:diagnosis* / Q000517:prevention & control*
keywords: Arrhythmias; Endocardial mapping; Epicardial mapping; Non-invasive mapping system
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