A clinical pilot study on the accessory pathway localization accuracy applying ECG mapping

Noninvasive imaging of cardiac electrophysiology provides in a noninvasive way information about electrical excitation. Our objective was to quantify the localization error of noninvasive activation time (AT) imaging by localizing an accessory pathway for a Wolff-Parkinson-White syndrome and a pacing site for left ventricle pacing. Anatomical data obtained by magnetic resonance imaging and electrocardiographic mapping enables the imaging of the AT map on the entire surface of the heart. The nonlinear inverse problem is solved by a sequence of linearized ill-posed problems. The localization accuracy in this clinical pilot study for localizing a single pacing site and an accessory pathway was 8 mm and 5 mm with a inaccuracy of this distance of 10 mm. The presented clinical pilot study shows that the proposed noninvasive activation time imaging approach permits the reconstruction of single focal events with sufficiently accuracy for potential clinical application.