Duchateau Josselin, Potse Mark, Dubois Remi
IEEE Trans Biomed Eng. 2017 May;64(5):1149-1156. doi: 10.1109/TBME.2016.2593003. Epub 2016 Jul 19.
Cardiac mapping is an important diagnostic step in cardiac electrophysiology. One of its purposes is to generate a map of the depolarization sequence. This map is constructed in clinical routine either by directly analyzing cardiac electrograms (EGMs) recorded invasively or an estimate of these EGMs obtained by a noninvasive technique. Activation maps based on noninvasively estimated EGMs often show artefactual jumps in activation times. To overcome this problem, we present a new method to construct the activation maps from reconstructed unipolar EGMs.
On top of the standard estimation of local activation time from unipolar intrinsic deflections, we propose to mutually compare the EGMs in order to estimate the delays in activation for neighboring recording locations. We then describe a workflow to construct a spatially coherent activation map from local activation times and delay estimates in order to create more accurate maps. The method is optimized using simulated data and evaluated on clinical data from 12 different activation sequences.
We found that the standard methodology created lines of artificially strong activation time gradient. The proposed workflow enhanced these maps significantly.
Estimating delays between neighbors is an interesting option for activation map computation in electrocardiographic imaging.
心脏标测是心脏电生理学中的一个重要诊断步骤。其目的之一是生成去极化序列图。在临床常规操作中，该图的构建要么是通过直接分析侵入性记录的心脏电图（EGM），要么是通过非侵入性技术获得的这些EGM的估计值。基于非侵入性估计的EGM的激活图在激活时间上常常显示出人为的跳跃。为了克服这个问题，我们提出了一种从重建的单极EGM构建激活图的新方法。
在从单极固有偏转进行局部激活时间的标准估计之上，我们建议相互比较EGM，以估计相邻记录位置的激活延迟。然后，我们描述了一种工作流程，用于从局部激活时间和延迟估计构建空间连贯的激活图，以便创建更准确的图。该方法使用模拟数据进行了优化，并在来自12种不同激活序列的临床数据上进行了评估。
我们发现标准方法产生了人为的强激活时间梯度线。所提出的工作流程显著增强了这些图。
估计相邻位置之间的延迟是心电图成像中激活图计算的一个有趣选项。
