Jiang Mingfeng, Xia Ling, Shou Guofa, Wei Qing, Liu Feng, Crozier Stuart
Department of Biomedical Engineering, Zhejiang University, Hangzhou 310027, China.
IEEE Trans Biomed Eng. 2009 Apr;56(4):923-31. doi: 10.1109/TBME.2008.2005967. Epub 2008 Oct 3.
Previous studies of the ECG inverse problem often assumed that the heart was static during the cardiac cycle; consequently, a time-dependent geometrical error was thought to be unavoidably introduced. In this paper, cardiac motion is included in solutions to the electrocardiographic inverse problem. Cardiac dynamics are simulated based on a previously developed biventricular model that coupled the electrical and mechanical properties of the heart, and simulated the ventricular wall motion and deformation. In the forward computation, the heart surface source model method is employed to calculate the epicardial potentials from the action potentials, and then, the simulated epicardial potentials are used to calculate body surface potentials. With the inclusion of cardiac motion, the calculated body surface potentials are more reasonable than those in the case of static assumption. In the epicardial potential-based inverse studies, the Tikhonov regularization method is used to handle ill-posedness of the ECG inverse problem. The simulation results demonstrate that the solutions obtained from both the static ECG inverse problem and the dynamic ECG inverse problem approaches are approximately the same during the QRS complex period, due to the minimal deformation of the heart in this period. However, with the most obvious deformation occurring during the ST-T segment, the static assumption of heart always generates something akin to geometry noise in the ECG inverse problem causing the inverse solutions to have large errors. This study suggests that the inclusion of cardiac motion in solving the ECG inverse problem can lead to more accurate and acceptable inverse solutions.
以往关于心电图逆问题的研究通常假定心脏在心动周期中是静止的;因此,人们认为不可避免地会引入与时间相关的几何误差。在本文中,心脏运动被纳入心电图逆问题的求解中。基于先前开发的双心室模型对心脏动力学进行模拟,该模型耦合了心脏的电学和力学特性,并模拟了心室壁的运动和变形。在正向计算中,采用心脏表面源模型方法根据动作电位计算心外膜电位,然后,将模拟的心外膜电位用于计算体表电位。考虑到心脏运动后,计算得到的体表电位比静态假设情况下的更合理。在基于心外膜电位的逆问题研究中,使用蒂霍诺夫正则化方法来处理心电图逆问题的不适定性。模拟结果表明,由于在此期间心脏变形最小,在QRS波群期间从静态心电图逆问题和动态心电图逆问题方法获得的解大致相同。然而,由于在ST-T段发生最明显的变形,心脏的静态假设在心电图逆问题中总是产生类似于几何噪声的东西,导致逆解有较大误差。本研究表明,在解决心电图逆问题时考虑心脏运动可以得到更准确和可接受的逆解。