Heart Rhythm
Volume 2, Issue 11 , Pages 1250-1252, November 2005

Electrocardiographic imaging (ECGI), a novel diagnostic modality used for mapping of focal left ventricular tachycardia in a young athlete

  • Anselma Intini, MD

      Affiliations

    • Department of Medicine (Cardiology), Case Western Reserve University/University Hospitals of Cleveland, Cleveland, Ohio
    • ,
  • Robert N. Goldstein, MD

      Affiliations

    • Department of Medicine (Cardiology), Case Western Reserve University/University Hospitals of Cleveland, Cleveland, Ohio
    • ,
  • Ping Jia, PhD

      Affiliations

    • Department of Biomedical Engineering, Case Western Reserve University/University Hospitals of Cleveland, Cleveland, Ohio
    • Authors Ping Jia and Charulatha Ramanathan are employees and stockholders of CardioInsight, Inc., a company that plans to commercialize electrocardiographic imaging as a clinical tool
    • ,
  • Charulatha Ramanathan, PhD

      Affiliations

    • Department of Biomedical Engineering, Case Western Reserve University/University Hospitals of Cleveland, Cleveland, Ohio
    • Authors Ping Jia and Charulatha Ramanathan are employees and stockholders of CardioInsight, Inc., a company that plans to commercialize electrocardiographic imaging as a clinical tool
    • ,
  • Kyungmoo Ryu, PhD

      Affiliations

    • Department of Biomedical Engineering, Case Western Reserve University/University Hospitals of Cleveland, Cleveland, Ohio
    • ,
  • Bartolomeo Giannattasio, MD, PhD

      Affiliations

    • Department of Medicine (Cardiology), Case Western Reserve University/University Hospitals of Cleveland, Cleveland, Ohio
    • ,
  • Robert Gilkeson, MD

      Affiliations

    • Department of Radiology, Case Western Reserve University/University Hospitals of Cleveland, Cleveland, Ohio
    • ,
  • Bruce S. Stambler, MD

      Affiliations

    • Department of Medicine (Cardiology), Case Western Reserve University/University Hospitals of Cleveland, Cleveland, Ohio
    • ,
  • Pedro Brugada, MD

      Affiliations

    • Cardiovascular Center Aalst/OLV Hospital, Aalst, Belgium
    • ,
  • William G. Stevenson, MD

      Affiliations

    • Department of Medicine (Cardiology) Brigham and Women’s Hospital, Boston, Massachusetts
    • ,
  • Yoram Rudy, PhD

      Affiliations

    • Department of Biomedical Engineering, Case Western Reserve University/University Hospitals of Cleveland, Cleveland, Ohio
    • Present affiliation: Cardiac Bioelectricity and Arrhythmia Center, Washington University in St. Louis, St. Louis, Missouri
    • ,
  • Albert L. Waldo, MD

      Affiliations

    • Department of Medicine (Cardiology), Case Western Reserve University/University Hospitals of Cleveland, Cleveland, Ohio
    • Corresponding Author InformationAddress reprint requests and correspondence: Albert L Waldo, MD, Division of Cardiology, University Hospitals of Cleveland, 11100 Euclid Avenue, Cleveland, Ohio 44106

Received 26 May 2005; accepted 17 August 2005. published online 03 September 2005.

We report the first clinical application of electrocardiographic imaging (ECGI), a new, noninvasive imaging modality for arrhythmias, in an athlete with focal ventricular tachycardia (VT) originating from a left ventricular (LV) diverticulum. A reconstructed map of the epicardial activation sequence during a single premature ventricular complex (PVC) of an identical QRS morphology to the clinical VT, generated from 224-electrode body surface ECGs and a chest CT (ECGI), localized the PVC to the site of the diverticulum. This correlated with subsequent maps obtained using standard techniques. We describe the first case that used ECGI to guide diagnosis and therapy of a clinical tachyarrhythmia.

Keywords:  Imaging , Mapping , Arrhythmia , Epicardial , Ventricular Tachycardia

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 The other authors have no conflict of interest to disclose.EDITOR’S NOTE: Although case reports are limited to four authors, we made an exception in this case because of its complexity and the need for collaboration among multiple experts.

PII: S1547-5271(05)02011-4

doi:10.1016/j.hrthm.2005.08.019

Heart Rhythm
Volume 2, Issue 11 , Pages 1250-1252, November 2005

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