Laura R Bear1, Peter R Huntjens2, Richard D Walton3, Olivier Bernus3, Ruben Coronel4, Rémi Dubois3. 1. Electrophysiology and Heart Modelling Institute (IHU-LIRYC), Fondation Bordeaux Université, Pessac, France; Université de Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux U1045, France; Inserm, U1045, Centre de Recherche Cardio-Thoracique de Bordeaux, France. Electronic address: laura.bear@ihu-liryc.fr. 2. Electrophysiology and Heart Modelling Institute (IHU-LIRYC), Fondation Bordeaux Université, Pessac, France; Université de Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux U1045, France; Inserm, U1045, Centre de Recherche Cardio-Thoracique de Bordeaux, France; CARIM School for Cardiovascular Diseases, Maastricht University MedicalCentre, Maastricht, The Netherlands. 3. Electrophysiology and Heart Modelling Institute (IHU-LIRYC), Fondation Bordeaux Université, Pessac, France; Université de Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux U1045, France; Inserm, U1045, Centre de Recherche Cardio-Thoracique de Bordeaux, France. 4. Electrophysiology and Heart Modelling Institute (IHU-LIRYC), Fondation Bordeaux Université, Pessac, France; Department of Experimental Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
Abstract
BACKGROUND: Poor identification of electrical dyssynchrony is postulated to be a major factor contributing to the low success rate for cardiac resynchronization therapy. OBJECTIVE: The purpose of this study was to evaluate the sensitivity of body surface mapping and electrocardiographic imaging (ECGi) to detect electrical dyssynchrony noninvasively. METHODS: Langendorff-perfused pig hearts (n = 11) were suspended in a human torso-shaped tank, with left bundle branch block (LBBB) induced through ablation. Recordings were taken simultaneously from a 108-electrode epicardial sock and 128 electrodes embedded in the tank surface during sinus rhythm and ventricular pacing. Computed tomography provided electrode and heart positions in the tank. Epicardial unipolar electrograms were reconstructed from torso potentials using ECGi. Dyssynchrony markers from torso potentials (eg, QRS duration) or ECGi (total activation time, interventricular delay [D-LR], and intraventricular markers) were correlated with those recorded from the sock. RESULTS: LBBB was induced (n = 8), and sock-derived activation maps demonstrated interventricular dyssynchrony (D-LR and total activation time) in all cases (P < .05) and intraventricular dyssynchrony for complete LBBB (P < .05) compared to normal sinus rhythm. Only D-LR returned to normal with biventricular pacing (P = .1). Torso markers increased with large degrees of dyssynchrony, and no reduction was seen during biventricular pacing (P > .05). Although ECGi-derived markers were significantly lower than recorded (P < .05), there was a significant strong linear relationship between ECGi and recorded values. ECGi correctly diagnosed electrical dyssynchrony and interventricular resynchronization in all cases. The latest site of activation was identified to 9.1 ± 0.6 mm by ECGi. CONCLUSION: ECGi reliably and accurately detects electrical dyssynchrony, resynchronization by biventricular pacing, and the site of latest activation, providing more information than do body surface potentials.
BACKGROUND: Poor identification of electrical dyssynchrony is postulated to be a major factor contributing to the low success rate for cardiac resynchronization therapy. OBJECTIVE: The purpose of this study was to evaluate the sensitivity of body surface mapping and electrocardiographic imaging (ECGi) to detect electrical dyssynchrony noninvasively. METHODS: Langendorff-perfused pig hearts (n = 11) were suspended in a human torso-shaped tank, with left bundle branch block (LBBB) induced through ablation. Recordings were taken simultaneously from a 108-electrode epicardial sock and 128 electrodes embedded in the tank surface during sinus rhythm and ventricular pacing. Computed tomography provided electrode and heart positions in the tank. Epicardial unipolar electrograms were reconstructed from torso potentials using ECGi. Dyssynchrony markers from torso potentials (eg, QRS duration) or ECGi (total activation time, interventricular delay [D-LR], and intraventricular markers) were correlated with those recorded from the sock. RESULTS: LBBB was induced (n = 8), and sock-derived activation maps demonstrated interventricular dyssynchrony (D-LR and total activation time) in all cases (P < .05) and intraventricular dyssynchrony for complete LBBB (P < .05) compared to normal sinus rhythm. Only D-LR returned to normal with biventricular pacing (P = .1). Torso markers increased with large degrees of dyssynchrony, and no reduction was seen during biventricular pacing (P > .05). Although ECGi-derived markers were significantly lower than recorded (P < .05), there was a significant strong linear relationship between ECGi and recorded values. ECGi correctly diagnosed electrical dyssynchrony and interventricular resynchronization in all cases. The latest site of activation was identified to 9.1 ± 0.6 mm by ECGi. CONCLUSION: ECGi reliably and accurately detects electrical dyssynchrony, resynchronization by biventricular pacing, and the site of latest activation, providing more information than do body surface potentials.
Authors: Thomas Grandits; Karli Gillette; Aurel Neic; Jason Bayer; Edward Vigmond; Thomas Pock; Gernot Plank Journal: J Comput Phys Date: 2020-07-03 Impact factor: 3.553
Authors: Ali S Rababah; Laura R Bear; Yesim Serinagaoglu Dogrusoz; Wilson Good; Jake Bergquist; Job Stoks; Rob MacLeod; Khaled Rjoob; Michael Jennings; James Mclaughlin; Dewar D Finlay Journal: Comput Biol Med Date: 2021-07-21 Impact factor: 6.698
Authors: Matthijs Cluitmans; Dana H Brooks; Rob MacLeod; Olaf Dössel; María S Guillem; Peter M van Dam; Jana Svehlikova; Bin He; John Sapp; Linwei Wang; Laura Bear Journal: Front Physiol Date: 2018-09-20 Impact factor: 4.566
Authors: Laura R Bear; Richard D Walton; Emma Abell; Yves Coudière; Michel Haissaguerre; Olivier Bernus; Rémi Dubois Journal: Front Physiol Date: 2019-02-26 Impact factor: 4.566
Authors: Pavel Jurak; Laura R Bear; Uyên Châu Nguyên; Ivo Viscor; Petr Andrla; Filip Plesinger; Josef Halamek; Vlastimil Vondra; Emma Abell; Matthijs J M Cluitmans; Rémi Dubois; Karol Curila; Pavel Leinveber; Frits W Prinzen Journal: Sci Rep Date: 2021-06-01 Impact factor: 4.379