Selection of optimal recording sites for limited lead body surface potential mapping in myocardial infarction and left ventricular hypertrophy

Finlay, Dewar; Nugent, Chris; Donnelly, Mark; Black, Norman D.

doi:10.1016/j.jelectrocard.2008.02.009

Cited by 6 publications

(8 citation statements)

References 24 publications

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“…The number of electrodes necessary for BSPM utilization has been mostly evaluated for ventricular activity based on the quality of the signals . Only few studies investigated the role of the number and distribution of BSPM leads in studying atrial electrophysiology.…”

Section: Discussionmentioning

confidence: 99%

“…The aim of this study is to determine the minimal configuration of body surface leads necessary to noninvasively identify the atria presumably driving AF to facilitate the incorporation of the noninvasive BSPM approach into the clinical practice. Previous studies have already investigated how the selection of different leads’ sets affects the electrocardiogram (ECG) waveform, and have concluded that for AF signals, systems with more than 32 electrodes do not increase the signal reconstruction accuracy . However, the ability of these lead sets to characterize the nature and position of possible AF drivers has not been studied.…”

Section: Introductionmentioning

confidence: 99%

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Minimal configuration of body surface potential mapping for discrimination of left versus right dominant frequencies during atrial fibrillation

Rodrigo

Climent

Liberos

et al. 2017

Pacing Clinical Electrophis

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Background Ablation of drivers maintaining Atrial Fibrillation (AF) has been demonstrated as an effective therapy. Drivers in the form of rapidly-activated atrial regions can be non-invasively localized to either left or right atria (LA, RA) with Body Surface Potential Mapping (BSPM) systems. This study quantifies the accuracy of Dominant Frequency (DF) measurements from reduced-leads BSPM systems and assesses the minimal configuration required for ablation guidance. Methods Nine uniformly distributed lead sets of 8 to 66 electrodes were evaluated. BSPM signals were registered simultaneously with intracardiac electrocardiograms (EGMs) in 16 AF patients. DF activity was analyzed on the surface potentials for the 9 leads configurations, and the non-invasive measures were compared with the EGM recordings. Results Surface DF measurements presented similar values than panoramic invasive EGM recordings, showing the highest DF regions in corresponding locations. The non-invasive DFs measures had a high correlation with the invasive discrete recordings; they presented a deviation <0.5 Hz for the highest DF and a correlation coefficient >0.8 for leads configurations with 12 or more electrodes. Conclusions Reduced-leads BSPM systems enable non-invasive discrimination between LA versus RA dominant frequencies with similar results as higher-resolution 66-leads system. Our findings demonstrate the possible incorporation of simplified BSPM systems into clinical planning procedures for AF ablation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Minimal configuration of body surface potential mapping for discrimination of left versus right dominant frequencies during atrial fibrillation

Rodrigo

Climent

Liberos

et al. 2017

Pacing Clinical Electrophis

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“…It has been reported that although only about 10 statistically independent components can be identified in the electrocardiographic signal in sinus rhythm [Hoekema 1999], around 30 leads are needed to reconstruct the surface signal correctly [Lux 1978]. This number has been reported similar for ventricular signals [Finlay 2008, Guillem 2009]. In the case of atrial arrhythmias, our group reported that about 34 leads were sufficient to reconstruct the surface electric activity [Guillem 2009].…”

Section: Comparison With Previous Studiessupporting

confidence: 53%

“…The position of these 30 electrodes was not uniform across the torso surface, being the front side of the torso the densest area. More recently, a study by Finlay et al in a population of healthy and myocardial infarction patients observed that 32 electrodes were enough to provide an acceptable level of reconstruction, but in this case different configuration of the electrodes yielded little differences in the ECG signals [Finlay 2008]. In agreement to this, we conducted a study in patients with myocardial infarction, bundle-branch block, and ventricular hypertrophy patients and found that increasing the lead number above 30 electrodes had little effect on the ECG signal and the leads configuration had little importance on the signal reconstruction, which was more dependent on the population under study [Guillem 2009].…”

Section: Lead Distribution In Body Surface Electrocardiographymentioning

confidence: 99%

“…For the DF inter-atrial distribution, even less leads could be enough. In spite of the disorganized AF signal nature, the BSPM systems for the study of the AF seem to need the same amount of electrodes (about 32) as the BSPM systems for the study of ventricular non-fibrillation arrhythmias [Lux 1978, Finlay 2008, Guillem 2008, Guillem 2009]. This observation is also consistent with the natural smoothening filtering effect of the torso volume conductor that projects on the torso surface only the strongest characteristics of the atrial waves, with reduced sensitivity for the small electrical waves, no matter how many leads are used for mapping.…”

Section: Lead Distribution In Body Surface Electrocardiographymentioning

confidence: 99%

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Non-invasive identification of atrial fibrillation drivers.

Bort¹

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AgraïmentsLa realització d'una tesi doctoral es per una part el treball científic més important en la carrera d'un jove investigador, però d'altra part també representa el proces vital que completa l'etapa d'aprenentage i dona pas a l'etapa adulta. Aquesta tesi ha suposat doncs no sols un proces de desenvolupament científic, sino també un desenvolupament personal modelat per les relacions humanes en aquest període involucrades. Per això, em cal agrair a totes aquelles persones que han fet posible el transcórrer d'aquest treball la seua participació.En primer lloc, he tingut el plaer de treballar amb persones de les que he aprés molt més del que els podré agrair: Edu, Conrad, Xavi, Santi, Jaume, Adolfo, Cristina, Ramón, Ismael, Toni, Álvaro, Paco, Javier, Lluis, Laia, Irene i molts més. També he d'agraïr a Pepe la seua aposta per un jove teleco que poc més que ganes de treballar podía oferir. Gràcies especials a Alejandro i a Jorge, el vostre treball ha sigut indispensable per a aquesta tesi, i heu sigut uns excelents companys tant en el treball com en l'oci. Espere que totes aquestes relacions pervisquen per molts anys.María i Andreu, rebeu el meu sincer agraïment, vostra ajuda i direcció ha sigut indispensable, i el vostre treball incansable. Sou responsables de que hui en dia el grup de investigació siga el que és, i a més heu conseguit convertir-lo en una gran família. També m'és indispensable agrair a Omer Berenfeld la ajuda que desde l'altra part del Atlantic m'ha proporcionat, així com a l'acolliment amb els braços oberts durant l'estada en el seu grup d'Ann Arbor. També he d'agrair de manera especial la ajuda del doctor Felipe Atienza en aquesta tesi.Per altra banda, i de manera infinitament més ampla, tinc que donar gràcies als meus pares, sense els quals no haguera pogut recorrer ni una fracció del camí que m'ha dut fins ací. A ma mare, de la que he heretat la que espere serà la meua professió en els pròxims passos d'aquest camí, la docència. I per extensió, a tots els mestres que m'han conduït fins ací i m'han permés vore el món des dels muscles d'un gegant.Per últim, a la persona més important de la meua vida, en la que compartisc aquest camí i fa que sols tinga sentit poder recorrer-lo amb ella. Aquest treball ha sigut gràcies a tu.iii

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A priori model independent inverse potential mapping: the impact of electrode positioning

et al. 2015

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IntroductionIn inverse potential mapping, local epicardial potentials are computed from recorded body surface potentials (BSP). When BSP are recorded with only a limited number of electrodes, in general biophysical a priori models are applied to facilitate the inverse computation. This study investigated the possibility of deriving epicardial potential information using only 62 torso electrodes in the absence of an a priori model.MethodsComputer simulations were used to determine the optimal in vivo positioning of 62 torso electrodes. Subsequently, three different electrode configurations, i.e., surrounding the thorax, concentrated precordial (30 mm inter-electrode distance) and super-concentrated precordial (20 mm inter-electrode distance) were used to record BSP from three healthy volunteers. Magnetic resonance imaging (MRI) was performed to register the electrode positions with respect to the anatomy of the patient. Epicardial potentials were inversely computed from the recorded BSP. In order to determine the reconstruction quality, the super-concentrated electrode configuration was applied in four patients with an implanted MRI-conditional pacemaker system. The distance between the position of the ventricular lead tip on MRI and the inversely reconstructed pacing site was determined.ResultsThe epicardial potential distribution reconstructed using the super-concentrated electrode configuration demonstrated the highest correlation (R = 0.98; p < 0.01) with the original epicardial source model. A mean localization error of 5.3 mm was found in the pacemaker patients.ConclusionThis study demonstrated the feasibility of deriving detailed anterior epicardial potential information using only 62 torso electrodes without the use of an a priori model.Electronic supplementary materialThe online version of this article (doi:10.1007/s00392-015-0891-7) contains supplementary material, which is available to authorized users.

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Selection of optimal recording sites for limited lead body surface potential mapping in myocardial infarction and left ventricular hypertrophy

Cited by 6 publications

References 24 publications

Minimal configuration of body surface potential mapping for discrimination of left versus right dominant frequencies during atrial fibrillation

Minimal configuration of body surface potential mapping for discrimination of left versus right dominant frequencies during atrial fibrillation

Non-invasive identification of atrial fibrillation drivers.

A priori model independent inverse potential mapping: the impact of electrode positioning

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