Basic/Translational Science -> Computer Modeling/Simulation D-PO03 - Poster Session III (ID 48) Poster

D-PO03-015 - Utility Of In-silico Pace Mapping To Successfully Identify Simulated Vt Exit Sites Non-invasively Using Both 12-lead Ecg Recordings And Electrograms From Implanted Devices (ID 270)


Background: Pace-mapping is a time-consuming and invasive procedure for localizing optimal ablation sites, requiring an existing VT-ECG recording. Patient-specific computational models have the potential to perform non-invasive pace-maps to be used in pre-procedural planning with the ability to probe a higher density of sites.
Objective: To perform virtual pace-mapping and compare the most correlated pace-map sites with the known VT exit site from the model using both QRS complexes from 12-lead ECG and implanted device (ICD) electrograms (EGMs) VT recordings.
Methods: A detailed 3D computational torso was used to generate ECGs during 50 different pacing locations around the infarct border. Correlation analysis was performed between paced QRS complexes and simulated VT QRSs, and between ICD EGMs, to visually identify VT exit sites.
Results: Correlations between paced and VT QRSs were consistently higher close to the identified VT exit site (Fig c), with areas of low correlation corresponding to slow conducting isthmuses. Correlations of paced QRSs between individual pacing sites were also able to successfully identify the preferable pathway of the reentrant circuit and slow conducting isthmus. Correlation analysis between paced EGMs and VT EGM (and between paced EGM QRSs) from ICDs produced comparable pace-maps (Fig d).
Conclusion: Our virtual patient-specific pace-mapping pipeline is able to produce high-density maps which reliably identify ablation targets. We have further demonstrated the potential to use automatically recorded VT-data from implanted devices to produce similar high-fidelity pace-maps for pre-procedure ablation planning.