Physense, Universitat Pompeu Fabra, Roc de Boronat 138, 08018 Barcelona, Spain.
Computational Multiscale Physiology Lab (CoMMLab), Department of Computer Science, Universitat de Valencia, 46100 Valencia, Spain.
Med Image Anal. 2015 Aug;24(1):52-62. doi: 10.1016/j.media.2015.05.007. Epub 2015 May 21.
The electrical activation of the heart is a complex physiological process that is essential for the understanding of several cardiac dysfunctions, such as ventricular tachycardia (VT). Nowadays, patient-specific activation times on ventricular chambers can be estimated from electro-anatomical maps, providing crucial information to clinicians for guiding cardiac radio-frequency ablation treatment. However, some relevant electrical pathways such as those of the Purkinje system are very difficult to interpret from these maps due to sparsity of data and the limited spatial resolution of the system. We present here a novel method to estimate these fast electrical pathways from the local activations maps (LATs) obtained from electro-anatomical maps. The location of Purkinje-myocardial junctions (PMJs) is estimated considering them as critical points of a distance map defined by the activation maps, and then minimal cost geodesic paths are computed on the ventricular surface between the detected junctions. Experiments to validate the proposed method have been carried out in simplified and realistic simulated data, showing good performance on recovering the main characteristics of simulated Purkinje networks (e.g. PMJs). A feasibility study with real cases of fascicular VT was also performed, showing promising results.
心脏的电激活是一个复杂的生理过程，对于理解几种心脏功能障碍（如室性心动过速[VT]）至关重要。如今，可从电解剖图中估计心室腔的患者特定激活时间，为临床医生提供指导心脏射频消融治疗的关键信息。然而，由于数据稀疏和系统空间分辨率有限，一些相关的电通路（如浦肯野系统）非常难以从这些图中解释。我们在此提出了一种从电解剖图获得的局部激活图（LAT）中估计这些快速电通路的新方法。考虑到浦肯野-心肌连接点（PMJ）是由激活图定义的距离图的关键点，因此可以在检测到的连接点之间的心室表面上计算最小代价测地线路径。已经在简化和现实模拟数据中进行了验证该方法的实验，结果表明其在恢复模拟浦肯野网络的主要特征（例如 PMJ）方面表现良好。还进行了真实束状 VT 病例的可行性研究，结果有一定的潜力。
