- Poster presentation
- Open Access
Human & swine studies of concurrent 12-lead ECG & MRI
© Tse et al; licensee BioMed Central Ltd. 2013
- Published: 30 January 2013
- Left Anterior Descend
- Atrial Fibrillation Patient
- Acute Ischemia
- Distal Left Anterior Descend
- Swine Study
12-lead Electrocardiogram (ECG) is a clinical standard for patient physiological monitoring. An MRI-conditional 12-lead ECG should permit detection of acute myocardial ischemia during MR imaging or MRI-guided therapy, which may improve the handling of patients with ischemic histories. MRI visualization of ischemic episodes can also enhance the understanding of ischemic progression. Previously an MR-conditional 12-lead ECG system was presented. The system was equipped with Gradient-Ramp&RF (GR&RF) noise removal hardware & Magnetohydrodynamic (VMHD) voltage-removal software that improved ST segment visualization . The study objectives were to (1) validate simultaneous 12-lead ECG monitoring & cardiac MR imaging in human subjects; (2) detect S-wave to T-wave (ST) ECG elevation & perform MR imaging of a Left Anterior Descending (LAD) balloon occlusion from the onset of ischemia to death in a swine model.
1) AF patient's ECG processing & MRI (Fig1): (a) Raw ECG V6 was dominated by GR&RF noise during a GRE scan. (b) GR&RF noise was removed using the hardware circuit, leaving real ECG superimposed with VMHD. (c) Real ECG was extracted. (d) Beat-to-beat stroke volume (BTB-SV) was estimated from VMHD, where varying ventricular filling due to changing heart rates is responsible for irregular BTB-SV results. ST segment was well preserved for ischemia monitoring (c, e-f). The system outputted 100% accurate scan triggers at <30ms latency, allowing cine MRI in subjects where 4-lead ECG gating failed due to stronger VMHD peaks (g).
2) Acute Ischemia in Swine (Fig2): ST elevation was detected 1.5 seconds after onset (a1), progressing to acute ischemia (a2-3), bradycardia and death. Ventricular dysfunction and unusual flow vortexes were visualized with serial cine MRI (c1-4). Epicardial edema was observed adjacent to the balloon (d).
MRI-conditional 12-lead ECG provides high-fidelity ECGs for robust cardiac-MRI. Acute ischemia detection is possible, with simultaneous MRI visualization of dysfunction progression.
NIH U41-RR019703, R43 HL110427-01, AHA 10SDG261039
- Tse ZTH: . ISMRM. ‘09-'11Google Scholar
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.