Electrocardiographic imaging: back to the drawing board?

摘要

Cardiac resynchronization therapy (CRT) is established treatment for patients who have left ventricular ejection fraction <0.35, heart failure symptoms after optimal medical management, and QRS width SI20 ms. However, not all such patients respond to treatment, and the best method for determining who will respond remains uncertain. Nevertheless, the QRS complex width and morphology are predictive.Electrocardiographic imaging (ECGI) registers multiple body surface ECGs via patient-specific heart-torso anatomy derived from ECG-gated computed tomographic scans to derive a detailed view of electrical ventricular activation beyond that available on the surface 12-lead ECG. Although variants of ECGI have existed for more than 20 years,1 a clinical role has not been established.