Electrocardiographic Imaging

Book excerpt: Electrical activity in the myocardium coordinates the contraction of the heart, and its knowledge could lead to a better understanding, diagnosis, and treatment of cardiac diseases. This electrical activity generates an electromagnetic field that propagates outside the heart and reaches the human torso surface, where it can be easily measured. Classical electrocardiography aims to interpret the 12-lead electrocardiogram (ECG) to determine cardiac activity and support the diagnosis of cardiac pathologies such as arrhythmias, altered activations, and ischemia. More recently, a higher number of leads is used to reconstruct a more detailed quantitative description of the electrical activity in the heart by solving the so-called inverse problem of electrocardiography. This technique is known as ECG imaging. Today, clinical applications of ECG imaging are showing promising results in guiding a variety of electrophysiological interventions such as catheter ablation of atrial fibrillation and ventricular tachycardia. However, in order to promote the adoption of ECG imaging in the routine clinical practice, further research is required regarding more accurate mathematical methods, further scientific validation under different preclinical scenarios and a more extensive clinical validation