Influence of Torso Model Complexity on the Noninvasive Localization of Ectopic Ventricular Activity

Punshchykova, O.; Svehlikova, Jana; Tyšler, Milan; Grünes, Richard; Sedova, Ksenia; Osmančík, Pavel; Zdarska, Jana; Heřman, Dalibor; Kneppo, Peter

doi:10.1515/msr-2016-0013

Cited by 16 publications

(12 citation statements)

References 26 publications

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“…In the clinical practice, where the noise is unavoidable part of the measurement, the selected time interval representing ectopic activity should be of longer duration. Nevertheless, our study in patients [15] had shown that using this method and increasing the time interval for IBSPM computation up to 15 ms allows to localize the PVC origin with a LE within 2 cm. As the obtained mean LE using noise-free input data was about 5-6 mm, the study also suggests that smaller grid dimension for the possible positions of the PVC origin would probably not improve the accuracy of the method.…”

Section: Critical Success Factorsmentioning

confidence: 87%

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Impact of the Position of Ectopic Ventricular Activation Origin on Its Noninvasive Assessment: A Simulation Study

Deutsch¹,

Tyšler²,

Kneppo³

2018

AMS

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The accuracy of a method for noninvasive localization of the origin of premature ventricular complex (PVC) was tested on simulated data. The method is based on inverse solution in terms of a single dipole that uses integrals of body surface potentials (BSPs) and a model of the torso volume conductor. ECGSIM software was used to simulate ectopic activation in a realistic ventricular model and BSPs on an inhomogeneous torso. Ectopic activation origins were simulated in 120 positions located in anterior, lateral, posterior, and septal segments of the right and left ventricle (RV, LV). In both septal segments 15 endocardial positions were specified, in all other segments 5 epicardial, 5 endocardial, and 5 in the valvular region were defined. Corresponding BSPs for initial 5 ms interval of the ectopic activity were simulated in 300 torso nodes as well as in 192 points representing BSP mapping leads. Simulated BSPs and the torso model with lungs and heart cavities were then used for the inverse localization of each PVC origin. The localization error (LE) was defined as the distance between the simulated and inversely estimated PVC origin position. All simulated PVC origins were localized in the correct ventricular segment. There was no significant difference between the LEs in the RV and LV, except the septal segments where the LE was significantly smaller in the RV (p<0.05). There were no significant differences between the LEs obtained using BSP maps from 300 torso nodes or 192 mapping leads (mean values LE300=5.2±4.4 mm and LE192=5.3±4.5 mm).

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Section: Critical Success Factorsmentioning

confidence: 87%

“…To solve this issue, regularization methods limiting the mathematical model are used [12][13][14]. In the case of PVC origin, a small activated region is localized and the cardiac generator can be modeled by a single dipole [15].…”

Section: Introductionmentioning

confidence: 99%

Impact of the Position of Ectopic Ventricular Activation Origin on Its Noninvasive Assessment: A Simulation Study

Deutsch¹,

Tyšler²,

Kneppo³

2018

AMS

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“…It was assumed that if the PVC starts in one position in the ventricle then during the initial phase of activation only small area is depolarized, that can be represented by a single equivalent heart generator. This approach was used in [4] for DIPs. In presented study the approach was used for all available generators.…”

Section: Methodsmentioning

confidence: 99%

“…The reconstructed generator is usually computed in the form of epicardial potentials, transmembrane voltages or equivalent double layer [2], [3]. In [4] a single dipole was reconstructed. Because the inverse problem is ill posed, various regularization methods are tested and computational aspects are studied [5] to receive stable and physiological results.…”

Section: Introductionmentioning

confidence: 99%

Noninvasive Localization of Premature Ventricular Activity Using Different Equivalent Point Sources

Svehlikova

Tyšler

2016

2016 Computing in Cardiology Conference (CinC)

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IntroductionOne of the aims of electrocardiographic imaging methods (inverse methods in ECG) is the noninvasive identification of the origin of a premature ventricular contraction (PVC) [1]. Reliable results could be helpful for planning the ablation procedure used for the treatment of such heart disease. Calculation of the inverse results depends on the type of equivalent heart generator used in mathematical formulation of the problem. The aim of this study was to compare the single point inverse solutions assuming three types of a heart generator from the measured repeated PVCs in one patient. Materials and methodsMeasured body surface potential maps (BSPMs) were used as the input data for the inverse solution. The ECG signals were recorded in 63 precordial leads during nine spontaneous ectopic beats (PVCs) in one patient undergoing the ablation procedure [9] (patient 20). The measured dataset was provided in EDGAR database by the Institute of Biomedical Engineering, Karlsruhe Institute of Technology (KIT), Germany and the First Department of Medicine (Cardiology), University Medical Centre Mannheim, Germany. From the ablation procedure two reference points indicating possible origins of the spontaneous PVC were assigned with the CARTO system: PVC1 -the site where the earliest activation time was recorded and PVC2 -the site of the latest successful ablation.The patient-specific geometry was obtained from MR scans taken in the end-diastolic phase and described by surface triangular meshes of the geometry of the torso and heart ventricles.In EDGAR database the precomputed forward transfer matrices computed by boundary element method for two types of equivalent heart generators were provided: epicardial potentials (EPs) and transmembrane voltages (TMVs). The positions of the generators were assumed in the vertices of the joined triangulated endo and epicardial surface. The transfer matrix for dipoles (DIPs) situated in the same vertices was also computed.The single point inverse solution for localization of the

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“…Over the past four decades, ECGI has seen considerable development, from purely analytical studies ( Rudy et al, 1979 ; Figuera et al, 2016 ; Svehlikova et al, 2018 ), to torso tank ( Oster et al, 1997 , 1998 ; Ramanathan and Rudy, 2001 ; Shome and Macleod, 2007 ; Bear et al, 2018a ) and large animal models ( Liu et al, 2012 ; Oosterhoff et al, 2016 ; Cluitmans et al, 2017 ; Bear et al, 2018b ) and finally application in humans ( Ghanem et al, 2005 ; Horáček et al, 2011 ; Haissaguerre et al, 2014 ; Schulze, 2015 ; Punshchykova et al, 2016 ). It is now increasingly used for academic research and in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Validation and Opportunities of Electrocardiographic Imaging: From Technical Achievements to Clinical Applications

et al. 2018

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Electrocardiographic imaging (ECGI) reconstructs the electrical activity of the heart from a dense array of body-surface electrocardiograms and a patient-specific heart-torso geometry. Depending on how it is formulated, ECGI allows the reconstruction of the activation and recovery sequence of the heart, the origin of premature beats or tachycardia, the anchors/hotspots of re-entrant arrhythmias and other electrophysiological quantities of interest. Importantly, these quantities are directly and non-invasively reconstructed in a digitized model of the patient’s three-dimensional heart, which has led to clinical interest in ECGI’s ability to personalize diagnosis and guide therapy. Despite considerable development over the last decades, validation of ECGI is challenging. Firstly, results depend considerably on implementation choices, which are necessary to deal with ECGI’s ill-posed character. Secondly, it is challenging to obtain (invasive) ground truth data of high quality. In this review, we discuss the current status of ECGI validation as well as the major challenges remaining for complete adoption of ECGI in clinical practice. Specifically, showing clinical benefit is essential for the adoption of ECGI. Such benefit may lie in patient outcome improvement, workflow improvement, or cost reduction. Future studies should focus on these aspects to achieve broad adoption of ECGI, but only after the technical challenges have been solved for that specific application/pathology. We propose ‘best’ practices for technical validation and highlight collaborative efforts recently organized in this field. Continued interaction between engineers, basic scientists, and physicians remains essential to find a hybrid between technical achievements, pathological mechanisms insights, and clinical benefit, to evolve this powerful technique toward a useful role in clinical practice.

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Influence of Torso Model Complexity on the Noninvasive Localization of Ectopic Ventricular Activity

Cited by 16 publications

References 26 publications

Impact of the Position of Ectopic Ventricular Activation Origin on Its Noninvasive Assessment: A Simulation Study

Impact of the Position of Ectopic Ventricular Activation Origin on Its Noninvasive Assessment: A Simulation Study

Noninvasive Localization of Premature Ventricular Activity Using Different Equivalent Point Sources

Validation and Opportunities of Electrocardiographic Imaging: From Technical Achievements to Clinical Applications

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