Mean Temporal Spatial Isochrones Direction as Marker for Activation Delay in Patients with Arrhythmogenic Cardiomyopathy

Abstract

Patients with arrhythmogenic cardiomyopathy (ACM) often present with ventricular arrhythmias due to local activation delay. Early detection of activation delay could aid in preventing sudden cardiac death. The aim of this feasibility study is to use a novel ECG analysis method, the mean temporal spatial isochrones (meanTSI), as marker of activation delay. We included 16 patients with symptomatic ACM, 6 asymptomatic ACM and 6 controls. The standard 12 lead ECG and a standard heart model were used to construct the meanTSI 25 ms after the end of the QRS complex. Asymptomatic mutation carriers had significantly more meanTSI movement in the basal plane compared to Controls and ACM patients with prolonged QRS duration. This meanTSI algorithm might become a novel screening method to quantify the activation delay in patients with ACM and asymptomatic mutation carriers in a non-invasive manner.