The Electrophysiological Cardiac Ventricular Substrate in Patients After Myocardial Infarction

Cuculich, Phillip S.; Zhang, Junjie; Wang, Yong; Desouza, Kavit A.; Vijayakumar, R.; Woodard, Pamela K.; Rudy, Yoram

doi:10.1016/j.jacc.2011.07.029

Cited by 83 publications

(74 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In a recent report in human subjects, ECM provided accurate identification of anatomic scar and scar-related electrophysiological characteristics of low voltage, altered sinus rhythm activation, electrogram fractionation, and presence of ventricular late potentials. 16 All of the above indicates that ECM can be a useful primary diagnostic approach to obtain the desired activation data and identify the mechanism of abnormal rhythms.…”

Section: Discussionmentioning

confidence: 99%

Confirmation of Novel Noninvasive High-Density Electrocardiographic Mapping With Electrophysiology Study

Cakulev

Sahadevan

Arruda

et al. 2013

Circ: Arrhythmia and Electrophysiology

View full text Add to dashboard Cite

Background— Twelve lead ECGs have limited value in precisely identifying atrial and ventricular activation during arrhythmias, including accessory atrioventricular conduction activation. The aim of this study was to report a single center’s clinical experience validating a novel, noninvasive, whole heart, beat-by-beat, 3-dimensional mapping technology with invasive electrophysiological studies, including ablation, where applicable. Methods and Results— Using an electrocardiographic mapping (ECM) system in 27 patients, 3-dimensional epicardial activation maps were generated from >250 body surface ECGs using heart–torso geometry obtained from computed tomographic images. ECM activation maps were compared with clinical diagnoses, and confirmed with standard invasive electrophysiological studies mapping. (1) In 6 cases of Wolff–Parkinson–White syndrome, ECM accurately identified the ventricular insertion site of an accessory atrioventricular connection. (2) In 10 patients with premature ventricular complexes, ECM accurately identified their ventricular site of origin in 8 patients. In 2 of 10 patients transient premature ventricular complex suppression was observed during ablation at the site predicted by ECM as the earliest. (3) In 10 cases of atrial tachycardia/atrial flutter, ECM accurately identified the chamber of origin in all 10, and distinguished isthmus from nonisthmus dependent atrial flutter. (4) In 1 patient with sustained exercise induced ventricular tachycardia, ECM accurately identified the focal origin in the left ventricular outflow tract. Conclusions— ECM successfully provided valid activation sequence maps obtained noninvasively in a variety of rhythm disorders that correlated well with invasive electrophysiological studies.

show abstract

Section: Discussionmentioning

confidence: 99%

Confirmation of Novel Noninvasive High-Density Electrocardiographic Mapping With Electrophysiology Study

Cakulev

Sahadevan

Arruda

et al. 2013

Circ: Arrhythmia and Electrophysiology

View full text Add to dashboard Cite

show abstract

“…A degree of discrepancy between CMR and EAM is expected as CMR can struggle to detect areas of homogenous microscopic diffuse fibrosis due to the low resolution of the image, while inverse ECG EAM can be more sensitive at detecting zones of epicardial and transmural fibrosis but may miss sub-endocardial scar. Despite this, good correlation has been observed between areas of low voltage on ECGI and areas of scar, as identified on LGE-CMR [80] with one study quoting an 89% sensitivity and 85% specificity at detecting epicardial scar [81]. …”

Section: Tissue Characterizationmentioning

confidence: 99%

Optimal site selection and image fusion guidance technology to facilitate cardiac resynchronization therapy

Sieniewicz

Gould

Porter

et al. 2018

Expert Review of Medical Devices

View full text Add to dashboard Cite

Introduction: Cardiac resynchronization therapy (CRT) has emerged as one of the few effective treatments for heart failure. However, up to 50% of patients derive no benefit. Suboptimal left ventricle (LV) lead position is a potential cause of poor outcomes while targeted lead deployment has been associated with enhanced response rates. Image-fusion guidance systems represent a novel approach to CRT delivery, allowing physicians to both accurately track and target a specific location during LV lead deployment.Areas covered: This review will provide a comprehensive evaluation of how to define the optimal pacing site. We will evaluate the evidence for delivering targeted LV stimulation at sites displaying favorable viability or advantageous mechanical or electrical properties. Finally, we will evaluate several emerging image-fusion guidance systems which aim to facilitate optimal site selection during CRT.Expert commentary: Targeted LV lead deployment is associated with reductions in morbidity and mortality. Assessment of tissue characterization and electrical latency are critical and can be achieved in a number of ways. Ultimately, the constraints of coronary sinus anatomy have forced the exploration of novel means of delivering CRT including endocardial pacing which hold promise for the future of CRT delivery.

show abstract

“…Future research is expected to continue this iterative process of coconstruction of the MSE system in human electrophysiology driven by recent technical developments for the characterization of human cardiac electrophysiology, including gene expression screening, in vitro optical mapping recordings (32,37,56), and noninvasive electrocardiographic imaging (27,28). This coincides with the availability of advanced computational tools for complex multiscale simulations and improvement in computer power.…”

Section: H150 Bridging Experiments Models and Simulations In Electrmentioning

confidence: 97%

Bridging experiments, models and simulations: an integrative approach to validation in computational cardiac electrophysiology

Carusi

Burrage

Rodríguez

2012

American Journal of Physiology-Heart and Circulatory Physiology

View full text Add to dashboard Cite

Carusi A, Burrage K, Rodríguez B. Bridging experiments, models and simulations: an integrative approach to validation in computational cardiac electrophysiology. Am J Physiol Heart Circ Physiol 303: H144 -H155, 2012. First published May 11, 2012; doi:10.1152/ajpheart.01151.2011.-Computational models in physiology often integrate functional and structural information from a large range of spatiotemporal scales from the ionic to the whole organ level. Their sophistication raises both expectations and skepticism concerning how computational methods can improve our understanding of living organisms and also how they can reduce, replace, and refine animal experiments. A fundamental requirement to fulfill these expectations and achieve the full potential of computational physiology is a clear understanding of what models represent and how they can be validated. The present study aims at informing strategies for validation by elucidating the complex interrelations among experiments, models, and simulations in cardiac electrophysiology. We describe the processes, data, and knowledge involved in the construction of whole ventricular multiscale models of cardiac electrophysiology. Our analysis reveals that models, simulations, and experiments are intertwined, in an assemblage that is a system itself, namely the model-simulation-experiment (MSE) system. We argue that validation is part of the whole MSE system and is contingent upon 1) understanding and coping with sources of biovariability; 2) testing and developing robust techniques and tools as a prerequisite to conducting physiological investigations; 3) defining and adopting standards to facilitate the interoperability of experiments, models, and simulations; 4) and understanding physiological validation as an iterative process that contributes to defining the specific aspects of cardiac electrophysiology the MSE system targets, rather than being only an external test, and that this is driven by advances in experimental and computational methods and the combination of both. computational physiology; systems biology; computer simulations; whole ventricular models; cardiac electrophysiology COMPUTATIONAL PHYSIOLOGY belongs to the broad family of research in the life sciences referred to as systems biology. As with other domains of systems biology, it considers biological processes as systems of interacting components, and draws upon mathematical and computational modeling to bring these into new configurations with experimentation. It shares the basic commitments of systems biology to nonreductionist or integrative principles, geared towards the exploration of emergence and nonlinear interactions among components and between levels (12,16,41,49,53,71,88). From a sociological point of view, it is also a mode of research that depends on a high degree of interdisciplinary collaboration, where the increased sophistication of computational modeling in the life sciences can elicit high expectations but also skepticism sometimes, thus making collaboration more difficult (19,20,...

show abstract

The Electrophysiological Cardiac Ventricular Substrate in Patients After Myocardial Infarction

Cited by 83 publications

References 27 publications

Confirmation of Novel Noninvasive High-Density Electrocardiographic Mapping With Electrophysiology Study

Confirmation of Novel Noninvasive High-Density Electrocardiographic Mapping With Electrophysiology Study

Optimal site selection and image fusion guidance technology to facilitate cardiac resynchronization therapy

Bridging experiments, models and simulations: an integrative approach to validation in computational cardiac electrophysiology

Contact Info

Product

Resources

About