An Improved Iterative Pace-Mapping Algorithm to Detect the Origin of Premature Ventricular Contractions

Premature ventricular contraction (PVC) is one of the mechanisms that induce Ventricular Tachycardia (VT) or Ventricular Fibrillation (VF). A way to cure PVC is to ab-late the origin with an endocardial catheter. But it can be difficult, and sometimes impossible, to localize this exit site accurately enough. We propose to accelerate catheter ablation using an automatic method to guide the catheter towards the PVC origin. This method uses the QRS complex integrals of the 8-lead ECGs of the PVC and a sequence of beats paced at known locations. The method was tested using 7 realistic heart-torso models with PVCs in endocardial, epicardial, and intramural tissue. With 10 pacing sites, 95 % of the targets had been approximated to less than 5 mm. We conclude that although the convergence is sometimes erratic, the proposed method does converge to the origin, often within the radius of an ablation lesion.Plateforme multi-modale d'exploration en cardiologieL'Institut de Rythmologie et modélisation CardiaqueElectrostructural Tomography - Towards Multiparametric Imaging of Cardiac Electrical Disorder