Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System.

Rapid, safe, and effective cardiac mapping is critical for the management of complex arrhythmias, yet current methods face significant limitations. The 12-lead electrocardiogram (ECG), while essential for initial diagnosis, lacks the spatial resolution and depth needed to guide advanced procedures such as catheter ablation or cardiac resynchronization therapy device implantation. On the other hand, invasive mapping techniques provide detailed electrical activity but require multiple catheter placements, increasing procedural risks and complexity. These methods are time-consuming, expensive, and offer limited real-time assessment, especially in dynamic arrhythmias like atrial fibrillation (AF), unstable arrhythmia, and cardiac resynchronization therapy (CRT). This study introduces a noninvasive, imageless electrocardiographic imaging (Imageless-ECGI) system designed to complement traditional methods by providing real-time, beat-to-beat cardiac maps. Without the need for pre-procedural imaging, this system captures high-resolution electrical activity across the entire heart, offering a safer and more efficient alternative to invasive mapping. By combining the immediacy of surface recordings with the spatial accuracy of modern computational models, the Imageless-ECGI system bridges the gap between traditional ECG and invasive mapping, potentially transforming the workflow in electrophysiology labs.