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