Atrial location optimization by electrical measures for Electrocardiographic Imaging. (December 2020)

• Record Type: Journal Article
• Authors: Gisbert, Víctor; Jiménez-Serrano, Santiago; Roses-Albert, Eduardo; Rodrigo, Miguel
• Is Part Of: Computers in biology and medicine. Volume 127(2020)
• Publication Date: 2020-12
• Subjects: Inverse problem -- L-curve curvature -- Electrophysiology -- Mapping -- Dominant frequency -- Phase analysis -- Reentry -- Rotor; AF Atrial fibrillation -- DF Dominant Frequency -- ECG Electrocardiogram -- ECGI Electrocardiographic Imaging -- EGM Electrogram (Intracardiac) -- icEGM inverse-computed Electrogram; Medicine -- Data processing -- Periodicals; Biology -- Data processing -- Periodicals; 610.285
• DOI: 10.1016/j.compbiomed.2020.104031
• Languages: English
• ISSNs: 0010-4825

Abstract

Abstract: Background: The Electrocardiographic Imaging (ECGI) technique, used to non-invasively reconstruct the epicardial electrical activity, requires an accurate model of the atria and torso anatomy. Here we evaluate a new automatic methodology able to locate the atrial anatomy within the torso based on an intrinsic electrical parameter of the ECGI solution. Methods: In 28 realistic simulations of the atrial electrical activity, we randomly displaced the atrial anatomy for ±2.5 cm and ±30° on each axis. An automatic optimization method based on the L-curve curvature was used to estimate the original position using exclusively non-invasive data. Results: The automatic optimization algorithm located the atrial anatomy with a deviation of 0.5 ± 0.5 cm in position and 16.0 ± 10.7° in orientation. With these approximate locations, the obtained electrophysiological maps reduced the average error in atrial rate measures from 1.1 ± 1.1 Hz to 0.5 ± 1.0 Hz and in the phase singularity position from 7.2 ± 4.0 cm to 1.6 ± 1.7 cm (p < 0.01). Conclusions: This proposed automatic optimization may help to solve spatial inaccuracies provoked by cardiac motion or respiration, as well as to use ECGI on torso and atrial anatomies from different medical image systems. Highlights: Electrocardiographic Imaging requires location of heart within the torso to reconstruct the cardiac electrical activity. Intrinsic electrical parameters from ECGI reconstruction can be used to refine heart location. Automatic heart location on ECGI provides more accurate markers such as Dominant Frequency or Phase Singularities. This automatic algorithm may help to mitigate spatial inaccuracies by cardiac motion, respiration or co-registration.