Noninvasive functional imaging of volumetric cardiac electrical activity: a human study on myocardial infarction

Identification of infarct substrates provides necessary guidance to the prevention and treatment of cardiac arrhythmias. Compared to diagnostic criteria of body surface potentials (BSP) or electrophysiological information on heart surfaces, the underlying volumetric cardiac electrical activity is of more direct clinical relevance in exhibiting patient-specific arrhythmic dynamics and arrhythmogenic substrates. We have developed a paradigm for noninvasive imaging of volumetric myocardial transmembrane potential from BSPs. In this paper, we present a human study for a patient with acute myocardial infarction. Using patient MRI and BSP data, the framework is able to reconstruct details of the complete arrhythmic electrical activity on the 3D myocardium of the patient. Exploring a subset of the results, the extent, centroid and affected segments of the infarct is correctly evaluated, with comparable performance to existent best results. This human study demonstrates the potential of the presented paradigm as a noninvasive functional imaging technique for patient-specific volumetric cardiac electrical activity in practice.