Validation of Non-Invasive Electrophysiological Mapping Accuracy Using Endocardial Pacing With Three-Dimensional Non-Fluoroscopic Electroanatomical Mapping

Preoperative non-invasive diagnosis of ventricular arrhythmias allows to predict ablation effectiveness, reduces the operation and radiation exposure time. Previous studies based on comparison of the early activation zone with the anatomic location of the pacemaker's tip showed high accuracy of noninvasive mapping in cardiac regions of pacemaker implantation. However, understanding of ECG imaging precision in other anatomical areas is still limited. To determine the accuracy of non-invasive mapping and examine the reconstructed excitation patterns, endocardial ventricular pacing of different myocardium areas was conducted in combination with 3D Non-Fluoroscopic Electroanatomic Mapping. Results of invasive and non-invasive mappings were analyzed and qualitative comparison of pacing point locations was performed. Better results were obtained for free walls of ventricles and worse for septum, apical parts and outflow tracts.