Study: New imaging technology tops ECG for irregular heartbeat diagnosis

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March 25 (UPI) — A new ultrasound imaging approach may help improve diagnosis of cardiac arrhythmia, or irregular heartbeat, a new study suggests.

In findings published Wednesday in Science Translational Medicine, researchers from the Department of Biomedical Engineering and the Cardiac Electrophysiology Laboratory at Columbia University Medical Center demonstrated electromechanical wave imaging, a non-invasive approach that uses ultrasound to detect changes in heart contractions, was more than 96 percent accurate in spotting irregular heartbeat.

In comparison, electrocardiogram, or ECG, which is currently the most commonly used approach in the diagnosis of arrhythmia, has been estimated to have a 71 percent accuracy.

“Using electromechanical wave imaging as a clinical visualization tool in conjunction with ECG could improve planning discussions with patients about treatment options and pre-procedural planning, as well as potentially reducing redundant ablation sites, prolonged procedures and anesthesia times,” co-author Dr. Elisa E. Konofagou, a professor of biomedical engineering and radiology at Columbia University, told UPI.

According to the American Heart Association, millions of people in the United States live with arrythmias, including tachycardia and atrial fibrillation, or A-Fib. Some 3 million Americans have A-Fib.

Arrythmias can be controlled with medication, or treated with surgery, like catheter ablation, in which the tissue causing the irregular heartbeat is removed. Surgeons may also recommend the implantation of a device designed to control heartbeat, typically a pacemaker or implantable cardioverter defibrillator.

Study co-author Dr. Elaine Wan, a cardiologist at Columbia University Medical Center, told UPI that the current approach for diagnosing arrythmias, ECG, which has been used since the 19th century, uses invasive catheterization to map abnormal heart rhythm. She noted that the procedure can also take several hours to complete.

ECGs are also subject to interpretation from the test operator, meaning that clinicians can end up with inconsistent results and diagnoses.

After first testing electromechanical wave imaging in dogs, the researchers tested the approach in 55 patients with cardiac arrythmias, including those caused Wolff-Parkinson-White syndrome, atrial tachycardia and premature ventricular complexes.

The scientists found that by performing electromechanical wave imaging in all four chambers of the heart, they were able construct three-dimensional maps that revealed which areas of the organ were causing the arrhythmia in study participants.

“We were able to show that not only does our imaging method work in difficult cases of arrhythmia, but that it can also predict the optimal site of radiofrequency ablation before the procedure where there is no other imaging tool available to do that in the clinic,” Konofagou said.

The next steps, Wan said, are to see if the method can reduce procedure time, patient risk and improve outcomes.