Single-heartbeat electromechanical wave imaging with optimal strain estimation using temporally unequispaced acquisition sequences.

Electromechanical Wave Imaging (EWI) is a non-invasive, ultrasound-based imaging method capable of mapping the electromechanical wave (EW) in vivo, i.e. the transient deformations occurring in response to the electrical activation of the heart. Optimal imaging frame rates, in terms of the elastographic signal-to-noise ratio, to capture the EW cannot be achieved due to the limitations of conventional imaging sequences, in which the frame rate is low and tied to the imaging parameters. To achieve higher frame rates, EWI is typically performed by combining sectors acquired during separate heartbeats, which are then combined into a single view. However, the frame rates achieved remain potentially sub-optimal and this approach precludes the study of non-periodic arrhythmias. This paper describes a temporally unequispaced acquisition sequence (TUAS) for which a wide range of frame rates are achievable independently of the imaging parameters, while maintaining a full view of the heart at high beam density. TUAS is first used to determine the optimal frame rate for EWI in a paced canine heart in vivo and then to image during ventricular fibrillation. These results indicate how EWI can be optimally performed within a single heartbeat, during free breathing and in real time, for both periodic and non-periodic cardiac events.