Initial validation of a novel ECGI system for localization of premature ventricular contractions and ventricular tachycardia in structurally normal and abnormal hearts

Abstract

Background: View into Ventricular Onset (VIVO) is a novel ECGI system that uses 3D body surface imaging, myocardial CT/MRI, and 12‑lead ECG to localize earliest ventricular activation through analysis of simulated and clinical vector cardiograms.

Objective: To evaluate the accuracy of VIVO for the localization of ventricular arrhythmias (VA).

Methods: In twenty patients presenting for catheter ablation of VT [8] or PVC [12], VIVO was used to predict the site earliest activation using 12‑lead ECG of the VA. Results were compared to invasive electroanatomic mapping (EAM).

Results: A total of 22 PVC/VT morphologies were analyzed using VIVO. VIVO accurately predicted the location of the VA in 11/13 PVC cases and 8/9 VT cases. VIVO correctly predicted right vs left ventricular foci in 20/22 cases.

Conclusion: View into Ventricular Onset (VIVO) can accurately predict earliest activation of VA, which could aid in catheter ablation, and should be studied further.

Keywords: Electrocardiographic imaging; Non-invasive mapping; Premature ventricular contractions; Vectorcardiography; Ventricular tachycardia.