eprintid: 10072285 rev_number: 38 eprint_status: archive userid: 608 dir: disk0/10/07/22/85 datestamp: 2019-04-16 10:18:47 lastmod: 2021-12-18 23:55:23 status_changed: 2019-04-16 10:29:59 type: article metadata_visibility: show creators_name: Graham, AJ creators_name: Orini, M creators_name: Zacur, E creators_name: Dhillon, G creators_name: Daw, H creators_name: Srinivasan, NT creators_name: Lane, JD creators_name: Cambridge, A creators_name: Garcia, J creators_name: O'Reilly, NJ creators_name: Whittaker-Axon, S creators_name: Taggart, P creators_name: Lowe, M creators_name: Finlay, M creators_name: Earley, MJ creators_name: Chow, A creators_name: Sporton, S creators_name: Dhinoja, M creators_name: Schilling, RJ creators_name: Hunter, RJ creators_name: Lambiase, PD title: Simultaneous Comparison of Electrocardiographic Imaging and Epicardial Contact Mapping in Structural Heart Disease ispublished: pub divisions: UCL divisions: B02 divisions: D14 divisions: GA4 divisions: GA3 divisions: G17 keywords: ECG imaging, activation and repolarization maps, contact mapping, unipolar electrograms, ventricular tachycardia note: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. abstract: BACKGROUND: The accuracy of ECG imaging (ECGI) in structural heart disease remains uncertain. This study aimed to provide a detailed comparison of ECGI and contact-mapping system (CARTO) electrograms. METHODS: Simultaneous epicardial mapping using CARTO (Biosense-Webster, CA) and ECGI (CardioInsight) in 8 patients was performed to compare electrogram morphology, activation time (AT), and repolarization time (RT). Agreement between AT and RT from CARTO and ECGI was assessed using Pearson correlation coefficient, ρ AT and ρ RT, root mean square error, E AT and E RT, and Bland-Altman plots. RESULTS: After geometric coregistration, 711 (439-905; median, first-third quartiles) ECGI and CARTO points were paired per patient. AT maps showed ρ AT=0.66 (0.53-0.73) and E AT=24 (21-32) ms, RT maps showed ρ RT=0.55 (0.41-0.71) and E RT=51 (38-70) ms. The median correlation coefficient measuring the morphological similarity between the unipolar electrograms was equal to 0.71 (0.65-0.74) for the entire signal, 0.67 (0.59-0.76) for QRS complexes, and 0.57 (0.35-0.76) for T waves. Local activation map correlation, ρ AT, was lower when default filters were used (0.60 (0.30-0.71), P=0.053). Small misalignment of the ECGI and CARTO geometries (below ±4 mm and ±4°) could introduce variations in the median ρ AT up to ±25%. Minimum distance between epicardial pacing sites and the region of earliest activation in ECGI was 13.2 (0.0-28.3) mm from 25 pacing sites with stimulation to QRS interval <40 ms. CONCLUSIONS: This simultaneous assessment demonstrates that ECGI maps activation and repolarization parameters with moderate accuracy. ECGI and contact electrogram correlation is sensitive to electrode apposition and geometric alignment. Further technological developments may improve spatial resolution. date: 2019-04 date_type: published official_url: https://doi.org/10.1161/CIRCEP.118.007120 oa_status: green full_text_type: other language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 1645148 doi: 10.1161/CIRCEP.118.007120 lyricists_name: Lambiase, David lyricists_name: Orini, Michele lyricists_id: DLAMB45 lyricists_id: MORIN73 actors_name: Nonhebel, Lucinda actors_id: LNONH33 actors_role: owner full_text_status: public publication: Circulation: Arrhythmia and Electrophysiology volume: 12 number: 4 article_number: e007120 issn: 1941-3149 citation: Graham, AJ; Orini, M; Zacur, E; Dhillon, G; Daw, H; Srinivasan, NT; Lane, JD; ... Lambiase, PD; + view all <#> Graham, AJ; Orini, M; Zacur, E; Dhillon, G; Daw, H; Srinivasan, NT; Lane, JD; Cambridge, A; Garcia, J; O'Reilly, NJ; Whittaker-Axon, S; Taggart, P; Lowe, M; Finlay, M; Earley, MJ; Chow, A; Sporton, S; Dhinoja, M; Schilling, RJ; Hunter, RJ; Lambiase, PD; - view fewer <#> (2019) Simultaneous Comparison of Electrocardiographic Imaging and Epicardial Contact Mapping in Structural Heart Disease. Circulation: Arrhythmia and Electrophysiology , 12 (4) , Article e007120. 10.1161/CIRCEP.118.007120 <https://doi.org/10.1161/CIRCEP.118.007120>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10072285/1/Orini_Epicardial%20Validation%20of%20ECGi%20system_ms_R2%28UCL_deposited%29.pdf