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Reconstruction of three-dimensional biventricular activation based on the 12-lead electrocardiogram via patient-specific modelling
- Source :
- EP Europace, 23(4), 640-647. Oxford University Press, EP-Europace, EP-Europace, Oxford University Press (OUP): Policy B, 2020, ⟨10.1093/europace/euaa330⟩, Europace, EP-Europace, 2020, ⟨10.1093/europace/euaa330⟩
- Publication Year :
- 2021
-
Abstract
- Aims Non-invasive imaging of electrical activation requires high-density body surface potential mapping. The nine electrodes of the 12-lead electrocardiogram (ECG) are insufficient for a reliable reconstruction with standard inverse methods. Patient-specific modelling may offer an alternative route to physiologically constraint the reconstruction. The aim of the study was to assess the feasibility of reconstructing the fully 3D electrical activation map of the ventricles from the 12-lead ECG and cardiovascular magnetic resonance (CMR). Methods and results Ventricular activation was estimated by iteratively optimizing the parameters (conduction velocity and sites of earliest activation) of a patient-specific model to fit the simulated to the recorded ECG. Chest and cardiac anatomy of 11 patients (QRS duration 126–180 ms, documented scar in two) were segmented from CMR images. Scar presence was assessed by magnetic resonance (MR) contrast enhancement. Activation sequences were modelled with a physiologically based propagation model and ECGs with lead field theory. Validation was performed by comparing reconstructed activation maps with those acquired by invasive electroanatomical mapping of coronary sinus/veins (CS) and right ventricular (RV) and left ventricular (LV) endocardium. The QRS complex was correctly reproduced by the model (Pearson’s correlation r = 0.923). Reconstructions accurately located the earliest and latest activated LV regions (median barycentre distance 8.2 mm, IQR 8.8 mm). Correlation of simulated with recorded activation time was very good at LV endocardium (r = 0.83) and good at CS (r = 0.68) and RV endocardium (r = 0.58). Conclusion Non-invasive assessment of biventricular 3D activation using the 12-lead ECG and MR imaging is feasible. Potential applications include patient-specific modelling and pre-/per-procedural evaluation of ventricular activation.
- Subjects :
- CARDIAC ELECTROPHYSIOLOGY
medicine.medical_specialty
Patient-specific modelling
Heart Ventricles
0206 medical engineering
12 lead electrocardiogram
610 Medicine & health
02 engineering and technology
030204 cardiovascular system & hematology
Heart Ventricles/diagnostic imaging
Techincal Issues
11171 Cardiocentro Ticino
2705 Cardiology and Cardiovascular Medicine
Nerve conduction velocity
VALIDATION
03 medical and health sciences
QRS complex
Electrocardiography
2737 Physiology (medical)
0302 clinical medicine
[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
Physiology (medical)
Internal medicine
Eikonal model
medicine
Humans
magnetic resonance imaging
AcademicSubjects/MED00200
cardiovascular diseases
Endocardium
Coronary sinus
medicine.diagnostic_test
Ventricular activation • Three-dimensional activation
business.industry
Cardiac electrophysiology
Body Surface Potential Mapping
Magnetic resonance imaging
020601 biomedical engineering
Three-dimensional activation
Ventricular activation
Twelve-lead electrocardiogram
Cardiology
cardiovascular system
patient-specific modeling
business
Cardiology and Cardiovascular Medicine
Subjects
Details
- Language :
- English
- ISSN :
- 10995129 and 15322092
- Volume :
- 23
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- EP Europace
- Accession number :
- edsair.doi.dedup.....b5c3f9abb0aa01e74853c3fc48935f8f