The electrophysiological cardiac ventricular substrate in patients after myocardial infarction: noninvasive characterization with electrocardiographic imaging.

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  • Additional Information
    • Source:
      Publisher: Elsevier Biomedical Country of Publication: United States NLM ID: 8301365 Publication Model: Print Cited Medium: Internet ISSN: 1558-3597 (Electronic) Linking ISSN: 07351097 NLM ISO Abbreviation: J Am Coll Cardiol Subsets: MEDLINE
    • Publication Information:
      Original Publication: [New York, N.Y.] : Elsevier Biomedical, [c1983-
    • Subject Terms:
      Electrocardiography*; Heart Ventricles/*physiopathology ; Myocardial Infarction/*physiopathology; Adult ; Aged ; Aged, 80 and over ; Body Surface Potential Mapping ; Cicatrix/physiopathology ; Electromyography ; Electrophysiologic Techniques, Cardiac ; Female ; Humans ; Image Processing, Computer-Assisted ; Male ; Middle Aged
    • Abstract:
      Objectives: The aim of this study was to noninvasively image the electrophysiological (EP) substrate of human ventricles after myocardial infarction and define its characteristics.
      Background: Ventricular infarct border zone is characterized by abnormal cellular electrophysiology and altered structural architecture and is a key contributor to arrhythmogenesis. The ability to noninvasively image its electrical characteristics could contribute to understanding of mechanisms and to risk-stratification for ventricular arrhythmia.
      Methods: Electrocardiographic imaging, a noninvasive functional EP imaging modality, was performed during sinus rhythm (SR) in 24 subjects with infarct-related myocardial scar. The abnormal EP substrate on the epicardial aspect of the scar was identified, and its location, size, and morphology were compared with the anatomic scar imaged by other noninvasive modalities.
      Results: Electrocardiographic imaging constructs epicardial electrograms that have characteristics of reduced amplitude (low voltage) and fractionation. Electrocardiographic imaging colocalizes the epicardial electrical scar to the anatomic scar with a high degree of accuracy (sensitivity 89%, specificity 85%). In nearly all subjects, SR activation patterns were affected by the presence of myocardial scar. Late potentials could be identified and were almost always within ventricular scar.
      Conclusions: Electrocardiographic imaging accurately identifies areas of anatomic scar and complements standard anatomic imaging by providing scar-related EP characteristics of low voltages, altered SR activation, electrogram fragmentation, and presence of late potentials.
      (Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
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    • Grant Information:
      1 UL1 RR024992-01 United States RR NCRR NIH HHS; R01 HL049054 United States HL NHLBI NIH HHS; R01HL-049054-18 United States HL NHLBI NIH HHS; TL1 RR024995 United States RR NCRR NIH HHS; 1 KL2 RR 024994-01 United States RR NCRR NIH HHS; 1 TL1 RR024995-01 United States RR NCRR NIH HHS; KL2 RR024994 United States RR NCRR NIH HHS; R01-HL-033343-26 United States HL NHLBI NIH HHS; UL1 RR024992 United States RR NCRR NIH HHS; R01 HL033343 United States HL NHLBI NIH HHS
    • Publication Date:
      Date Created: 20111025 Date Completed: 20111213 Latest Revision: 20220316
    • Publication Date:
      20231215
    • Accession Number:
      PMC3365586
    • Accession Number:
      10.1016/j.jacc.2011.07.029
    • Accession Number:
      22018301