Volumetric non-invasive cardiac mapping for accessible global arrhythmia characterization

Area of Science:

• Cardiology
• Biomedical Engineering
• Medical Imaging

Background:

• Cardiac arrhythmias increase risk of stroke, heart failure, and sudden death.
• Non-invasive electrocardiographic imaging (ECGI) maps cardiac electricity from body surface potentials.
• Conventional ECGI reconstructs epicardial activity, limiting accuracy for deep myocardial arrhythmias.

Purpose of the Study:

• To overcome limitations of surface-ECGI by reconstructing three-dimensional (3D) cardiac electrical activity.
• To improve the localization of arrhythmias in anatomically complex regions.

Main Methods:

• Developed a volumetric formulation solving an inverse source problem using Green's functions.
• Enabled 3D reconstructions of cardiac activation beyond epicardial potentials.
• Evaluated on simulated data and clinical cases including PVCs, LBBB, VT, and WPW.

Main Results:

• Volumetric ECGI reconstructs 3D cardiac activation, enhancing arrhythmia origin localization.
• Achieved a 59.3% reduction in geodesic error compared to surface-only methods.
• Patient data showed recovered activation patterns consistent with clinical diagnoses.

Conclusions:

• Imageless volumetric ECGI provides non-invasive, 3D cardiac activation mapping.
• Addresses limitations of surface-restricted methods for improved arrhythmia identification.
• Potential to enhance pre-procedural planning, guide ablation, and optimize CRT selection.