In the Journals

Novel imaging modality localizes atrial, ventricular arrhythmias

Elaine Y. Wan

Electromechanical wave imaging, a high-frame rate ultrasound technique, localized atrial and ventricular arrhythmias including premature ventricular complexes, Wolff-Parkinson-White syndrome, atrial tachycardias and atrial flutter, according to a study published in Science Translational Medicine.

“The current standard of care using invasive electrophysiology studies can take several hours for an electrophysiologist to map arrhythmias,” Elaine Y. Wan, MD, FACC, FAHA, FHRS, Esther Aboodi Assistant Professor of Cardiology (in Medicine) at Columbia University Vagelos College of Physicians and Surgeons, told Healio. “Conducting this research enables us to identify how using novel noninvasive imaging with ultrasound can delivery precision cardiac care to patients and localize where their abnormal heart rhythm is coming from.”

Christopher S. Grubb, MD, resident in the division of cardiology at Columbia University Vagelos College of Physicians and Surgeons, and colleagues analyzed data from 55 patients (mean age, 56 years; 71% men) who presented for catheter ablation for arrhythmias including premature ventricular complexes, Wolff-Parkinson-White syndrome, atrial tachycardias and atrial flutter. All patients underwent transthoracic electromechanical wave imaging and 12-lead ECG.

“Electrocardiogram has been used since the 19th century by physicians to diagnose abnormal heart rhythm and where they come from,” Wan said in an interview. “In this article, we present a novel modality of using a noninvasive ultrasound technique called electromechanical wave imaging to localize arrhythmias in three dimensions.”

Researchers developed a standardized segmented cardiac model that integrated 3D isochrones rendered by electromechanical wave imaging and predictions by six electrophysiologists from 12-lead ECGs. This was then compared with 3D electroanatomical maps of the region of successful ablation using invasive catheter mapping.

This novel modality predicted 96% of arrhythmia locations vs. 71% with 12-lead ECG analyses (OR = 11.8; 95% CI, 2.2-63.2; adjusted for arrhythmia type OR = 12.1; 95% CI, 2.3-63.2).

“Using this novel imaging modality, we hope to empower cardiologists to discuss with patients where their arrhythmia is coming from and for electrophysiologists to know where they need to go to eradicate the abnormal heart rhythm,” Wan told Healio. – by Darlene Dobkowski

For more information:

Elaine Y. Wan, MD, FACC, FAHA, FHRS, can be reached at eyw2003@cumc.columbia.edu.

Disclosures: Wan reports she has been a speaker for Abbott and Medtronic and is an inventor on several patents held by the Trustees of Columbia University in the City of New York. Grubb reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.

Elaine Y. Wan

Electromechanical wave imaging, a high-frame rate ultrasound technique, localized atrial and ventricular arrhythmias including premature ventricular complexes, Wolff-Parkinson-White syndrome, atrial tachycardias and atrial flutter, according to a study published in Science Translational Medicine.

“The current standard of care using invasive electrophysiology studies can take several hours for an electrophysiologist to map arrhythmias,” Elaine Y. Wan, MD, FACC, FAHA, FHRS, Esther Aboodi Assistant Professor of Cardiology (in Medicine) at Columbia University Vagelos College of Physicians and Surgeons, told Healio. “Conducting this research enables us to identify how using novel noninvasive imaging with ultrasound can delivery precision cardiac care to patients and localize where their abnormal heart rhythm is coming from.”

Christopher S. Grubb, MD, resident in the division of cardiology at Columbia University Vagelos College of Physicians and Surgeons, and colleagues analyzed data from 55 patients (mean age, 56 years; 71% men) who presented for catheter ablation for arrhythmias including premature ventricular complexes, Wolff-Parkinson-White syndrome, atrial tachycardias and atrial flutter. All patients underwent transthoracic electromechanical wave imaging and 12-lead ECG.

“Electrocardiogram has been used since the 19th century by physicians to diagnose abnormal heart rhythm and where they come from,” Wan said in an interview. “In this article, we present a novel modality of using a noninvasive ultrasound technique called electromechanical wave imaging to localize arrhythmias in three dimensions.”

Researchers developed a standardized segmented cardiac model that integrated 3D isochrones rendered by electromechanical wave imaging and predictions by six electrophysiologists from 12-lead ECGs. This was then compared with 3D electroanatomical maps of the region of successful ablation using invasive catheter mapping.

This novel modality predicted 96% of arrhythmia locations vs. 71% with 12-lead ECG analyses (OR = 11.8; 95% CI, 2.2-63.2; adjusted for arrhythmia type OR = 12.1; 95% CI, 2.3-63.2).

“Using this novel imaging modality, we hope to empower cardiologists to discuss with patients where their arrhythmia is coming from and for electrophysiologists to know where they need to go to eradicate the abnormal heart rhythm,” Wan told Healio. – by Darlene Dobkowski

For more information:

Elaine Y. Wan, MD, FACC, FAHA, FHRS, can be reached at eyw2003@cumc.columbia.edu.

Disclosures: Wan reports she has been a speaker for Abbott and Medtronic and is an inventor on several patents held by the Trustees of Columbia University in the City of New York. Grubb reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.