Noninvasive Electrocardiographic Imaging of Scar-Related Ventricular Tachycardia: Association With Magnetic Resonance Scar Imaging

Abstract

A common setting for scar-related ventricular tachycardia is a reentry circuit formed by narrow channels of surviving tissue inside the myocardial scar. It is challenging to identify the critical components of these circuits using invasive catheter mapping due to its inability to map the vast majority of unstable VTs. While electrocardiographic imaging (ECGi) provides a promising noninvasive solution for rapid mapping of unstable VTs, its validation in the setting of scar-related VT remains challeging. In this paper, we report our initial results in the effort to integrate ECGi results with late gadolinium enhanced cardiac magnetic resonance imaging (LGE-cMR) of scar. We report quantitative association between ECGi features and CMR scar data, as well as qualitative relation between ECGi-reconstructed VT circuits and myocardial scar and critical channels identified from LGE-CMR data.