ECGI: Non-Invasive Electrocardiographic Imaging Can Pinpoint Arrhythmia

Because every patient’s arrhythmia is unique, precision in diagnosis and treatment is paramount. Electrocardiographic imaging (ECGI), an exciting advance in noninvasive cardiac imaging, can map an irregular heart rhythm in a single beat.

Invented by Yoram Rudy, PhD, the Fred Saigh Distinguished Professor of Engineering, professor of medicine, and director of the Cardiac Bioelectricity and Arrhythmia Center at Washington University, the vest-like device uses 256 electrodes combined with rapid CT scanning to display a patient’s cardiac electrophysiology in great detail. With accuracy of about six millimeters, the technology can pinpoint sites in the heart that initiate an arrhythmia.

Unlike invasive catheter studies, ECGI can map the arrhythmia in a single beat, such as a re-entry circuit during ventricular tachycardia, and it does so without the associated risk of catheter placement. ECGI also has the ability to image properties of cardiac repolarization and abnormal electrical substrates, such as those associated with myocardial infarction. Both repolarization and scar burden have roles in the development of sudden cardiac death. It is hoped that in the future, physicians may be able to use ECGI to identify high-risk patients before a life-threatening arrhythmic event has occurred.

“The information provided by this technology may eventually help physicians plan individualized medical treatment or target catheter ablation—all noninvasively,” says Phillip Cuculich, MD, one of seven Washington University electrophysiologists at Barnes-Jewish Hospital. Cuculich has worked with ECGI since 2006. “For patients, this ultimately translates into safer treatment plans with better cure rates.”