Noninvasive mapping of ventricular activation in patients with transplanted hearts

• Published in: Journal of electrocardiology Vol. 46; no. 6; pp. 698 - 701
• Main Authors: Desouza, Kavit A., MD, Joseph, Susan M., MD, Cuculich, Phillip S., MD, Ewald, Gregory A., MD, FACC, Rudy, Yoram, PhD, FAHA, FHRS
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2013
• Subjects: Adult; Aged; Algorithms; Body Surface Potential Mapping - methods; Cardiac transplantation; Cardiovascular; Conduction; ECGI; Electrocardiographic imaging; Female; Heart Transplantation - adverse effects; Heart Transplantation - methods; Humans; Male; Middle Aged; Premature ventricular complexes; Right ventricle; Treatment Outcome; Ventricular Dysfunction - diagnosis; Ventricular Dysfunction - etiology; Ventricular Premature Complexes - diagnosis; Ventricular Premature Complexes - etiology; Young Adult; ECGI; Conduction; Cardiac transplantation; Right ventricle; Electrocardiographic imaging; Premature ventricular complexes
• ISSN: 0022-0736; 1532-8430
• DOI: 10.1016/j.jelectrocard.2013.05.005

Abstract This is the first reported study of ventricular activation patterns after cardiac transplantation, using electrocardiographic imaging (ECGI), a noninvasive method for electrophysiologic mapping. This study of ten patients reveals that transplanted hearts have unique ventricular activation patterns in sinus rhythm, activating early in the epicardial aspect of the anterior or inferior septum, with intact right and left bundle branch conduction. They have late activation with slowing of conduction near the right ventricular (RV) basal free wall, causing a mild QRS prolongation and an rSr’ pattern in lead V1 of the ECG. PVCs arise from both endocardial and epicardial locations in both ventricles.