Mapping of ventricular arrhythmias using a novel noninvasive epicardial and endocardial electrophysiology system

Highlights

• Macro-reentrant circuits of scar-related VT can be visualized using a novel non-invasive electrophysiology system.

• In patients without myocardial scar and inducible polymorphic VT/VF, only rotor activity and multiple wavelets were observed.

• Use of the novel non-invasive electrophysiology system may help identify the optimal ablation strategy.

Abstract

Introduction

The aim of this study was to assess the use of a novel noninvasive epicardial and endocardial electrophysiology system (NEEES) for mapping of ventricular arrhythmias.

Methods

Eight patients (2 females, mean age 50 ± 17 years) with ischemic (n = 3) and nonischemic (n = 5) cardiomyopathy and inducible ventricular arrhythmias during electrophysiology study were enrolled. Noninvasive mapping of ventricular arrhythmias was performed using the NEEES based on body-surface electrocardiograms and computed tomography imaging data. Arrhythmia patterns were analyzed using noninvasive phase mapping.

Results

Macro-reentrant VT circuits were observed in 3 ischemic and 1 nonischemic cardiomyopathy patient, respectively. In the remaining 4 patients, phase mapping revealed relatively stable rotor activity and multiple wavelets.

Conclusions

Noninvasive cardiac mapping was able to visualize the macro-reentrant circuits in patients with scar-related VT. In patients without myocardial scar only polymorphic VT or VF was inducible, and rotor activity and multiple wavelets were observed.