Multiple lead ECG localization of the site of origin of ventricular tachycardia using catheter pace mapping techniques

A novel approach for the noninvasive localization of the site of origin of postinfarction ventricular tachycardia (VT) using single beat 62-lead body surface QRS integral maps is presented. It involves application of a detailed reference data base of paced segment specific QRS integral maps that was previously constructed using left ventricular pace mapping in patients with prior myocardial infarction. High-resolution electrocardiographic VT localization is obtained by associating each distinct VT QRS morphology with a circumscribed endocardial segment of ectopic activation onset. In electrophysiologicaly guided ablative therapy, body surface QRS integral mapping can serve as a complementary method to direct and shorten catheter activation mapping during VT and localize VTs that are not mappable with current catheter techniques.