Pranav Bhagirath

181 A priori model independent inverse potential mapping: the impact of electrode positioning Limitations of this study Application of 62 anterior electrodes with an inter-electrode distance of 20 mm enables detailed reconstruction of an anterior view of the epicardial potentials in the absence of an a priori model. Information on the posterior area of the heart could not be reconstructed from the BSP recorded using the anterior positioned super-concentrated electrode configuration. By increasing the total number of recording electrodes and by positioning electrodes on the back of the thorax this can be resolved. But since the application of a large number of electrodes is time consuming, implementation in the clinical arena may still be challenging. Hence, an optimal balance between information content and clinical utility is pursued. Parallel computation of the inverse solution will further reduce the post-processing time. In the presence of a limited number of electrodes, electrode positioning is crucial. In order to achieve a high resolution, it is very important to position the electrodes directly overlaying the heart. Because this may be difficult to determine, a rapid exploratory MRI scan (scout anatomical images) prior to BSPM may help to optimise electrode positioning. Regarding the small number of patients in this study, further research is needed to further evaluate the clinical benefits of this non-invasive mapping strategy. Future perspective Although IPM is consideredapromising technique to complement conventional invasive electrophysiological procedures, it has not yet advanced to routine clinical application. This is mainly due to the time consuming nature of the acquisition and post-processing of the data. The possibility to derive detailed information on cardiac excitation from a rapid and simplified BSPM procedure may facilitate clinical implementation. The ability to perform detailed simulations using patient data may provide clinicians valuable insight into the potential impact of their treatment. Non-invasive characterisation of arrhythmogenic foci or substrates, prior to invasive electrophysiological or device implant procedures, may help to increase therapeutic outcome. Further research is required to provide evidence of the effectiveness and accuracy of this approach to IPM. CONCLUSION The purpose of this study was to investigate the feasibility of IPM using only 62 torso electrodes without the aid of an a priori model. By concentrating the available electrodes in the area directly overlaying the heart, a high-resolution anterior view of the epicardial potentials can be obtained. Application of this mapping approach in patients with