Noninvasive Electrocardiographic Imaging with Magnetic Resonance Tomography in Candidates for Cardiac Resynchronization Therapy

Noninvasive electrocardiographic imaging (ECGI) with magnetic resonance tomography (MRI) is a promising technology raising clinical interest. In this manuscript, the method of qualitative comparison of late electrical activation zone’s position and area of fibrosis based on 17-segment approach is presented. To demonstrate performance of the proposed method, we studied sixty one patients scheduled as a potential candidates for cardiac resynchronization therapy. ECGI was performed using Amycard 01C EP LAB (EP Solutions SA, Switzerland). The late activation zone (LAZ) on a wide QRS complex with different morphology pattern was variable from anterior till inferior left ventricle (LV) wall. According to the MRI data, 41(67%) patients had fibrosis areas which did not coincide with the LAZ. 9(15%) participants had transmural scar involving epicardium of LV which localization coincided with the LAZ. In the remaining 11(18%) cases nontransmural scar excluding epicardial layer coincided with the LAZ. Taking these results into account, it is reasonable to assume that comparative qualitative analysis of ECGI and MRI data demonstrates coincidence of LAZ with fibrosis areas only in 33% of cases.