Institute of Biomedical Engineering, Karlsruhe Institute of Technology, Karlsruhe 76131, Germany.
IEEE Trans Biomed Eng. 2010 Oct;57(10):2394-401. doi: 10.1109/TBME.2010.2055056. Epub 2010 Jun 28.
Atrial arrhythmias, such as atrial flutter or fibrillation, are frequent indications for catheter ablation. Recorded intracardiac electrograms (EGMs) are, however, mostly evaluated subjectively by the physicians. In this paper, we present a method to quantitatively extract the wave direction and the local conduction velocity from one single beat in a circular mapping catheter signal. We simulated typical clinical EGMs to validate the method. We then showed that even with noise, the average directional error was below 10(°) and the average velocity error was below 5.4 cm/s. In a realistic atrial simulation, the method could clearly distinguish between stimuli from different pulmonary veins. We further analyzed eight clinical data segments from three patients in normal sinus rhythm and with stimulation. We obtained stable wave directions for each segment and conduction velocities between 70 and 115 cm/s. We conclude that the method allows for easy quantitative analysis of single macroscopic wavefronts in intracardiac EGMs, such as during atrial flutter or in typical clinical stimulation procedures after termination of atrial fibrillation. With corresponding simulated data, it can provide an interface to personalize electrophysiological (EP) models. Furthermore, it could be integrated into EP navigation systems to provide quantitative data of high diagnostic value to the physician.
心房心律失常，如房扑或房颤，是导管消融的常见适应证。然而，记录的心内电图（EGM）大多由医生进行主观评估。在本文中，我们提出了一种从圆形标测导管信号中的单个心动周期中定量提取波向和局部传导速度的方法。我们模拟了典型的临床 EGM 来验证该方法。结果表明，即使存在噪声，平均方向误差也低于 10（°），平均速度误差也低于 5.4cm/s。在真实的心房模拟中，该方法可以清楚地区分来自不同肺静脉的刺激。我们进一步分析了三个窦性节律患者的八个临床数据片段和刺激片段。我们获得了每个片段的稳定波向和 70-115cm/s 之间的传导速度。我们得出结论，该方法允许对心内 EGM 中的单个宏观波前进行简单的定量分析，例如在房扑期间或房颤终止后的典型临床刺激过程中。通过相应的模拟数据，它可以为电生理（EP）模型提供个性化接口。此外，它可以集成到 EP 导航系统中，为医生提供具有高诊断价值的定量数据。
