title: Noninvasive epicardial and endocardial mapping of premature ventricular contractions.
abstract: OBJECTIVE
  The aim of the present study was to estimate the accuracy of a novel non-invasive epicardial and endocardial electrophysiology system (NEEES) for mapping ectopic ventricular depolarizations.
  
  
  RESULTS
  The study enrolled 20 patients with monomorphic premature ventricular contractions (PVCs) or ventricular tachycardia (VT). All patients underwent pre-procedural computed tomography or magnetic resonance imaging of the heart and torso. Radiographic data were semi-automatically processed by the NEEES to reconstruct a realistic 3D model of the heart and torso. In the electrophysiology laboratory, body-surface electrodes were connected to the NEEES followed by unipolar EKG recordings during episodes of PVC/VT. The body-surface EKG data were processed by the NEEES using its inverse-problem solution software in combination with anatomical data from the heart and torso. The earliest site of activation as denoted on the NEEES 3D heart model was compared with the PVC/VT origin using a 3D electroanatomical mapping system. The site of successful catheter ablation served as final confirmation. A total of 21 PVC/VT morphologies were analysed and ablated. The chamber of interest was correctly diagnosed non-invasively in 20 of 21 (95%) PVC/VT cases. In 18 of the 21 (86%) cases, the correct ventricular segment was diagnosed. Catheter ablation resulted in acute success in 19 of the 20 (95%) patients, whereas 1 patient underwent successful surgical ablation. During 6 months of follow-up, 19 of the 20 (95%) patients were free from recurrence off antiarrhythmic drugs.
  
  
  CONCLUSIONS
  The NEEES accurately identified the site of PVC/VT origin. Knowledge of the potential site of the PVC/VT origin may aid the physician in planning a successful ablation strategy.
authors.affiliation: Asklepios Klinik St Georg, Hamburg, Germany.
authors.forename: Erik
authors.initials: E
authors.lastname: Wissner
authors.affiliation: Bakoulev Scientific Centre for Cardiovascular Surgery, Moscow, Russia.
authors.forename: Amiran
authors.initials: A
authors.lastname: Revishvili
authors.affiliation: Asklepios Klinik St Georg, Hamburg, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Metzner
authors.affiliation: EP Solutions SA, Yverdon-les-Bains, Switzerland.
authors.forename: Alexey
authors.initials: A
authors.lastname: Tsyganov
authors.affiliation: EP Solutions SA, Yverdon-les-Bains, Switzerland.
authors.forename: Vitaly
authors.initials: V
authors.lastname: Kalinin
authors.affiliation: Asklepios Klinik St Georg, Hamburg, Germany.
authors.forename: Christine
authors.initials: C
authors.lastname: Lemes
authors.affiliation: Asklepios Klinik St Georg, Hamburg, Germany.
authors.forename: Ardan M
authors.initials: AM
authors.lastname: Saguner
authors.affiliation: Asklepios Klinik St Georg, Hamburg, Germany.
authors.forename: Tilman
authors.initials: T
authors.lastname: Maurer
authors.affiliation: Asklepios Klinik St Georg, Hamburg, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Deiss
authors.affiliation: Bakoulev Scientific Centre for Cardiovascular Surgery, Moscow, Russia.
authors.forename: Oleg
authors.initials: O
authors.lastname: Sopov
authors.affiliation: Bakoulev Scientific Centre for Cardiovascular Surgery, Moscow, Russia.
authors.forename: Eugene
authors.initials: E
authors.lastname: Labarkava
authors.affiliation: EP Solutions SA, Yverdon-les-Bains, Switzerland.
authors.forename: Mikhail
authors.initials: M
authors.lastname: Chmelevsky
authors.affiliation: Asklepios Klinik St Georg, Hamburg, Germany.
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Kuck
mesh_terms: D000328:Adult; D000368:Aged; D018780:Body Surface Potential Mapping / Q000295:instrumentation* / Q000379:methods*; D003937:Diagnosis, Differential; D004699:Endocardium; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium; D011300:Preoperative Care / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D017180:Tachycardia, Ventricular / Q000175:diagnosis* / Q000601:surgery; D018879:Ventricular Premature Complexes / Q000175:diagnosis* / Q000601:surgery
keywords: Non-invasive epicardial and endocardial electrophysiology system; Non-invasive imaging; Premature ventricular contraction; Ventricular arrhythmias; Ventricular tachycardia