PERI-PROCEDURAL TRANSMURAL ELECTROPHYSIOLOGICAL IMAGING OF SCAR-RELATED VENTRICULAR TACHYCARDIA

Ventricular tachycardia (VT) is a serious condition that results in your heart beating much faster than its usual rate. Catheter ablation, which is burning the irregular electrical activity in the heart muscle through wires, is one of the methods that has been used in the treatment of VT. In order to treat this irregular activity, doctors must pinpoint the location of the electrical malfunction which typically involves inserting a catheter with an electrode tip into a blood vessel in the groin and snaking it up to the heart. By touching the tip to different places on the heart, doctors can create spatial and electrical maps. But these maps are usually incomplete as catheter can’t reach every part of the heart, leaving some areas of the map blank furthermore after VT ablation irregular heart rhythms can come back. Also, the mechanisms underlying this irregular heart rhythm is not well elucidated. Electrocardiographic imaging (ECGi) is an emerging technique to visualize the heart's electrical activity through reconstructions from body-surface recordings. After 40 years of active research, the potential of ECGi as a noninvasive adjunct to catheter mapping is gaining rapid attention in the clinical community and received US FDA clearance in 2017. Both ECGi and cardiac magnetic resonance imaging (MRI) are non-invasive methods which allow us to determine the diseased part of the heart causing the irregular heart rhythm and help us to visualize a panoramic view of the heart without going inside your heart through a catheter. In this study, we aim to show that images that are obtained with ECGi and combined with cardiac MRI are helpful in delineating the details of your irregular heart rhythm. We are hopeful that ECGi will provide us a better understanding on the underlying cause of heart rhythm abnormalities in ventricular tachycardia and would like to use ECGi as a clinical tool to improve the success and safety of VT ablation.