First experience in atrial activation imaging from clinical electrocardiographic mapping data

Activation time (AT) imaging from electrocardiographic (ECG) mapping data has become feasible under clinical conditions. First clinical results have recently been described on the validation of the sinus rhythm in the human ventricle. In this pilot study the AT imaging approach is applied for the first time to data of the human atrium. Because of the complex anatomy and of the small atrial signal electrical source, imaging is a huge challenge. The reconstructed AT pattern for the sinus rhythm on the endo- and epicardium was compared with the CARTO™ map obtained for the right atrium in a 21 year-old male patient. The geometrical error for the target chamber was found to be 4.8 mm. The spatial dislocation for the first endocardial breakthrough (sinus node activation) was determined with 5 mm.