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Assessment of the Site of Ventricular Activation by Fourier Analysis of Gated Blood-Pool Studies

Division of Nuclear Medicine, Department of Radiology, and Division of Cardiology, Department of Medicine, The Johns Hopkins Medical Institutions, Baltimore, Maryland

Correspondence: For reprints contact: Jonathan M. Links, PhD, Division of Nuclear Medicine, The Johns Hopkins Medical Institutions, 615 N. Wolfe St., Baltimore, MD 21205.

ABSTRACT

We studied the use of first-harmonic Fourier analysis of gated blood-pool images to assess the site of ventricular activation in a group of 12 patients undergoing electrophysiologic pacing studies. We acquired gated blood-pool studies during pacing at up to four sites at each of two different rates. A total of 50 studies were made. At a pacing rate of 100 beats/min, when the pacing electrode was at the right-ventricular apex, 9/13 times the Fourier activation site agreed; at the right-ventricular outflow tract, 7/8; at the anterolateral left-ventricular wall, 4/4. When the Fourier activation site was at the right-ventricular apex, 9/9 times the pacing electrode was there; at the right-ventricular outflow tract, 7/10; in the left ventricle, 4/4. Fourier analysis of gated blood-pool studies can help identify the site of ventricular activation but is not sufficiently accurate to fully replace endocardial mapping.

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