Electrophysiology of heart failure: Non-invasive mapping of substrate and guidance of cardiac resynchronization therapy with electrocardiographic imaging

Yoram Rudy

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

2 Scopus citations

Abstract

Electrocardiographic imaging (ECGI) computes electric potentials on the epicardial surfaces of the heart from measured potentials on the body surface. The high-resolution panoramic ECGI maps provide detailed information on the electrophysiological (EP) substrate and its dynamic modulation by pacing. This chapter explains the effects of cardiac resynchronization therapy (CRT) on ventricular activation and electrical synchrony. High-resolution, single-beat mapping with non-invasive ECGI of EP substrate and ventricular tachycardia (VT) in patients provides information that can facilitate CRT and substrate-based ablation of VT. Non-invasive ECGI is used to map cardiac electrical excitation in heart failure (HF) patients. Remodeling processes in HF alter the cell EP and calcium cycling, as well as the tissue structure, thus providing substrate for slow conduction and conduction block. ECGI could possibly be used to quantify electrical synchrony, identify potential responders/non-responders to CRT, and guide electrode placement for effective resynchronization.

Original languageEnglish
Title of host publicationCardiac Mapping
Publisherwiley
Pages220-235
Number of pages16
ISBN (Electronic)9781119152637
ISBN (Print)9781119152590
DOIs
StatePublished - Apr 5 2019

Keywords

  • Cardiac resynchronization therapy
  • Cell electrophysiological cycling
  • Electrocardiographic imaging
  • Electrophysiological substrate
  • Heart failure patients
  • Non-invasive mapping

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