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Am J Physiol Heart Circ Physiol 280: H179-H188, 2001;
0363-6135/01 $5.00
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Vol. 280, Issue 1, H179-H188, January 2001

Three-dimensional endocardial impedance mapping: a new approach for myocardial infarction assessment

Tamir Wolf1,*, Lior Gepstein1,*, Gal Hayam1, Asaph Zaretzky1, Rona Shofty1, Dina Kirshenbaum1, Gideon Uretzky2, Uri Oron3, and Shlomo A. Ben-Haim1

1 Cardiovascular System Laboratory, Bruce Rappaport Faculty of Medicine, and 2 Department of Cardiothoracic Surgery, Carmel Medical Center, Technion-Israel Institute of Technology, Haifa 31096; and 3 Department of Zoology, Tel-Aviv University, Tel-Aviv, Israel 69978

Precise identification of infarcted myocardial tissue is of importance in diagnostic and interventional cardiology. A three-dimensional, catheter-based endocardial electromechanical mapping technique was used to assess the ability of local endocardial impedance in delineating the exact location, size, and border of canine myocardial infarction. Electromechanical mapping of the left ventricle was performed in a control group (n = 10) and 4 wk after left anterior descending coronary artery ligation (n = 10). Impedance, bipolar electrogram amplitude, and endocardial local shortening (LS) were quantified. The infarcted area was compared with the corresponding regions in controls, revealing a significant reduction in impedance values [infarcted vs. controls: 168.8 ± 11.7 and 240.7 ± 22.3 Omega , respectively (means ± SE), P < 0.05] bipolar electrogram amplitude (1.8 ± 0.2 mV, 4.4 ± 0.7 mV, P < 0.05), and LS (-2.36 ± 1.6%, 11.9 ± 0.9%, P < 0.05). The accuracy of the impedance maps in delineating the location and extent of the infarcted region was demonstrated by the high correlation with the infarct area (Pearson's correlation coefficient = 0.942) and the accurate identification of the infarct borders in pathology. By accurately defining myocardial infarction and its borders, endocardial impedance mapping may become a clinically useful tool in differentiating healthy from necrotic myocardial tissue.

myocardial viability assessment; electromechanical coupling; electrophysiology


* Both authors contributed equally to this study.




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