Evidence map›Paper›PMID 41284114›Full record

ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2026

Electromechanical wave imaging vs electrocardiographic imaging: a direct comparison of non-invasive ventricular activation mapping modalities.

Johanna B Tonko, Melina Tourni, Aikaterini Afentouli, Joseph Hansen-Shearer, Biao Huang, Mengxing Tang, Anthony Chow, Elisa Konofagou, Pier D Lambiase

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Johanna B TonkoInstitute for Cardiovascular Science University College London, 5 University Street, London, UK.ORCID http://orcid.org/0000-0002-4689-8384
Melina TourniDepartment of Biomedical Engineering, Columbia University New York, New York, NY, 10001, USA.
Aikaterini AfentouliDepartment of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece.
Joseph Hansen-ShearerUltrasound Laboratory for Imaging and Sensing, Department of Bioengineering, Imperial College London, London, UK.
Biao HuangUltrasound Laboratory for Imaging and Sensing, Department of Bioengineering, Imperial College London, London, UK.
Mengxing TangUltrasound Laboratory for Imaging and Sensing, Department of Bioengineering, Imperial College London, London, UK.
Anthony ChowSt. Bartholomew S Hospital, Bart s NHS Health Trust, London, UK.
Elisa KonofagouDepartment of Biomedical Engineering, Columbia University New York, New York, NY, 10001, USA. ek2191@columbia.edu.
Pier D LambiaseInstitute for Cardiovascular Science University College London, 5 University Street, London, UK. p.lambiase@ucl.ac.uk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPrecise non-invasive identification of the site of origin (SoO) of ventricular arrhythmias (VA) could inform ablation strategies.

objectiveTo compare spatial accuracy of ultrasound-based electromechanical wave imaging (EWI) and ECG imaging (ECGI) to estimate the anatomical and axial (endo- vs epicardial) SoO of focal VA or pace maps employing contact mapping as gold standard.

methodsPatients awaiting a catheter ablation procedure underwent preprocedural EWI and ECGI to non-invasively map the SoO of VE/VT or RV and LV pacing sites. A commercial CT-ECGI system was used to reconstruct epicardial activation maps. Unipolar EGM morphology and slew rate were employed to estimate axial SoO. EWI was performed using high frame rate (2000fps) transthoracic echocardiography with simultaneous ECG. Contact mapping and pacing sites were used as gold standard to define SoOs.

resultsThirty-three patients with 36 maps in total were included, 24 patients for VE/VT activation and 9 for pace-mapping. ECGI correctly identified the segmental VA-SoO/pacing-site in 28/36 maps (77.8%) compared to 28/35 by EWI (80%, p = ns). Erroneous annotations in ECGI related to septal and papillary muscle foci, whereas EWI mostly misannotated in outflow tract and RV SoOs. One patient had insufficient VEs to allow EWI VA mapping. Reconstructed unipolar EGM features of ECGI maps did not reliably differentiate endo- from epicardial SoO. Direct transmural mapping with EWI correctly identified the "transmural" SoO in 27/35 (77.1%).

conclusionBoth EWI and ECGI localized the anatomical SoO in the majority of cases with site-specific advantages but also shortcomings for both modalities. EWI determines the transmural SoO which cannot be reliably localized using ECGI. ECGI has the advantage of providing mapping of multifocal and/or infrequent VA by offering panoramic single beat mapping.

Indexed as

Body Surface Potential MappingEchocardiographyElectrocardiographyElectrophysiologic Techniques, CardiacTachycardia, VentricularAgedCatheter AblationFemaleHumansMaleMiddle AgedReproducibility of ResultsSensitivity and SpecificityCatheter ablationElectrocardiographic imagingElectromechanical wave imagingNon-invasive mappingTransmural mappingVentricular arrhythmia

Identifiers

PMID41284114
PMCPMC13009115

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.