single-beat noninvasive imaging of ventricular endocardial and epicardial activation in patients undergoing crtsingle-beat无创性成像的心室心内膜和心外膜激活病人接受crt.pdf

Single-Beat Noninvasive Imaging of Ventricular Endocardial and Epicardial Activation in Patients Undergoing CRT 1 2 2 1 2 Thomas Berger *, Bernhard Pfeifer , Friedrich F. Hanser , Florian Hintringer , Gerald Fischer , Michael 2 3 1 1 2 Netzer , Thomas Trieb , Markus Stuehlinger , Wolfgang Dichtl , Christian Baumgartner , Otmar Pachinger1, Michael Seger2 1 Division of Cardiology, Department of Internal Medicine III, Medical University Innsbruck, Innsbruck, Austria, 2 Institute of Electrical, Electronic and Bioengineering, University for Health Sciences, Medical Informatics and Technology (UMIT), Hall in Tirol, Austria, 3 Department of Radiology I, Medical University Innsbruck, Innsbruck, Austria Abstract Background: Little is known about the effect of cardiac resynchronization therapy (CRT) on endo- and epicardial ventricular activation. Noninvasive imaging of cardiac electrophysiology (NICE) is a novel imaging tool for visualization of both epi- and endocardial ventricular electrical activation. Methodology/Principal Findings: NICE was performed in ten patients with congestive heart failure (CHF) undergoing CRT and in ten patients without structural heart disease (control group). NICE is a fusion of data from high-resolution ECG mapping with a model of the patient’s individual cardiothoracic anatomy created from magnetic resonance imaging. Beat- to-beat endocardial and epicardial ventricular activation sequences were computed during native rhythm as well as during ventricular pacing using a bidomain theory-based heart model to solve the related inverse problem. During right ventricular