Nature Medicine10, 422 - 428 (2004)
Published online: 14 March 2004; | doi:10.1038/nm1011
Noninvasive electrocardiographic imaging for cardiac electrophysiology and arrhythmia
Charulatha Ramanathan1, Raja N Ghanem1, Ping Jia1, Kyungmoo Ryu1
& Yoram Rudy1, 2
1
Cardiac Bioelectricity Research and Training Center, and Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio 44106-7207, USA.
2
Department of Physiology and Biophysics and Department of Medicine, Case Western Reserve University, Cleveland, Ohio 44106-7207, USA.
Correspondence should be addressed to Yoram Rudy yxr@po.cwru.edu
Over 7 million people worldwide die annually from erratic heart rhythms (cardiac arrhythmias), and many more are disabled. Yet there is no imaging modality to identify patients at risk, provide accurate diagnosis and guide therapy. Standard diagnostic techniques such as the electrocardiogram (ECG) provide only low-resolution projections of cardiac electrical activity on the body surface. Here we demonstrate the successful application in humans of a new imaging modality called electrocardiographic imaging (ECGI), which noninvasively images cardiac electrical activity in the heart. In ECGI, a multielectrode vest records 224 body-surface electrocardiograms; electrical potentials, electrograms and isochrones are then reconstructed on the heart's surface using geometrical information from computed tomography (CT) and a mathematical algorithm. We provide examples of ECGI application during atrial and ventricular activation and ventricular repolarization in (i) normal heart (ii) heart with a conduction disorder (right bundle branch block) (iii) focal activation initiated by right or left ventricular pacing, and (iv) atrial flutter.
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