Comparison of UHF-ECG with Other Noninvasive Electrophysiological Mapping Tools for Assessing Ventricular Dyssynchrony

This paper compares Ultra High Frequency ECG (UHF-ECG) with other techniques in the capacity to assess ventricular dyssynchrony. Ventricular dyssynchrony is important to identify patients that qualify for Cardiac Resynchronization Therapy (CRT) and to measure effects of CRT and other pacing therapies.Currently used tools are: duration of the QRS complex in the 12-lead ECG, vectorcardiographically determined QRSarea, ECG belt and ECG imaging. QRS duration is crude, QRSarea has been shown to predict CRT response in three large single center studies, ECG belt is a novel approach using 50-60 body surface electrodes and yields (variation in) activation times. ECG imaging requires cardiothoracic imaging and recordings using 150-250 electrodes and results in images of activation, which are converted into inter and intraventricular AT differences. UHF-ECG requires 12-14 lead ECG but provides two measures: (also) a measure of interventricular dyssynchrony (e-DYS) and a marker of width of the activation wavefront that reflects the contribution of rapid conduction. The latter is a unique feature that appears particularly useful in studies on different modes of physiological pacing.