Effects of Reducing the Number of Leads from Body Surface Potential Mapping in Computer Models of Atrial Arrhythmias

Abstract

Body surface potential mapping (BSPM) can be an important tool in ablation therapy planning. Results obtained with high resolution (HR) computer models must be translated to realistic numbers of leads. This study aims to evaluate the impact on atrial tachycardia (AT), flutter (AFL) and fibrillation (AF) characterization by reducing the number of BSPM leads. 19 realistic computer simulations with 567 leads (HR) have been used to characterize the arrhythmias concerning the dominant frequencies (DF) and phase singularity point (SP) distributions. DF maps were generated combining Welch periodogram and activation detection with wavelet transform modulus maxima. Phase was calculated with Hilbert transform on signals filtered around the highest DF (±1Hz); dynamics of SPs were analyzed using histograms (heatmaps, HMs) and connecting SPs along time (filaments). The analyses were reproduced for 6 layouts with 252 to 16 leads and results were compared using the structural similarity index (SSIM), sensitivity and precision in SP detection and analyzing features extracted from the maps. SSIM was lower in AF than in AFL or AT for DF maps and HMs, but was in average above 0.6 for layouts with 32 leads or more. In HMs, a loss in spatial resolution with fewer leads is reflected in decreasing values for sensitivity and precision. Features from DF maps, filaments or HMs were statistically equivalent in all layouts. HR 252 leads 131 leads 67 leads 64 leads 32 leads 16 leads Frequency Analysis AT 4.06 ± 0.03 4.06 ± 0.03 4.06 ± 0.03 5.04 ± 0.97 5.04 ± 0.97 4.06 ± 0.03 4.06 ± 0.03 AFL 4.09 ± 0.12 4.09 ± 0.12 4.09 ± 0.12 4.09 ± 0.12 4.09 ± 0.12 4.09 ± 0.12 4.09 ± 0.12 f d r i ve (Hz) AF 5.58 ± 0.23 5.58 ± 0.23 5.58 ± 0.23 5.37 ± 0.30 5.58 ± 0.23 5.56 ± 0.23 5.59 ± 0.22 AT 0.76 ± 0.70 1.28 ± 0.78 1.10 ± 0.69 2.26 ± 2.28 1.89 ± 1.61 0.67 ± 0.66 0.70 ± 0.67 AFL 0.24 ± 0.49 0.24 ± 0.49 0.24 ± 0.49 0.24 ± 0.49 0.24 ± 0.49 0.24 ± 0.49 0.24 ± 0.49