Noninvasive electrocardiographic imaging of activation sequence and substrate for ventricular tachycardia

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Ventricular arrhythmias are a major cause of sudden cardiac death worldwide. Ventricular tachycardia (VT) is a life-threatening arrhythmia that expresses in repetitive fast heart rhythm and can trigger even more lethal ventricular fibrillation. In clinical routine, a standard 12-lead ECG is employed for diagnosis of cardiac arrhythmias. However, it provides only global information on the heart condition and rests on cardiologists experience without taking into account patient-specific details. ECG imaging is an evolving technology allowing for noninvasive reconstruction of cardiac sources from body surface potential maps (BSPMs). In this research project, ECG imaging will be applied to reconstruct the activation sequence of ventricular tachycardias. To this end, data of patients with monomorphic VT will be collected, including MRI, electroanatomical mapping measurements and BSPMs. The quality of noninvasive reconstructions will then be evaluated against the intracardiac signals. Scars due to myocardial infarction will be imaged with DE-MRI. This way, the inverse problem solution will be evaluated with a focus on VT. Furthermore, ECG imaging will be combined with cardiac MRI to depict substrate modifications and to create models with patient-specific substrate properties for ECG imaging. This study will evaluate the clinical potential of ECGI for an improved risk stratification and personalized treatment planning for VT patients.