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起搏和心律失常期间心室激动的无创成像:方法与验证

Non-invasive imaging of ventricular activation during pacing and arrhythmia: Methods and validation.

作者信息

Pogwizd Steven

出版信息

Annu Int Conf IEEE Eng Med Biol Soc. 2016 Aug;2016:113-116. doi: 10.1109/EMBC.2016.7590653.

Abstract

Cardiovascular disease continued to be a leading killer world widely. Each year, about 400,000 cases of sudden cardiac arrest are reported in the U.S. alone. Clinically, radio-frequency ablative procedure has become widely applied in the treatment of ventricular arrhythmia. Non-invasive approaches have been demonstrated to be able to provide important information on the arrhythmogenesis and potentially assist in the clinical practice. In this work, we develop and validate a novel temporal sparse based imaging method, Cardiac Electrical Sparse Imaging (CESI). Computer simulation and animal validation results demonstrate that the CESI approach is capable of imaging with improved accuracy and robustness by exploiting the temporal sparse property underlying cellular electrophysiology. Overall, a CC of 0.8, RE of 0.2 and LE (localization error) of 7 mm has been achieved on human realistic simulation and good accuracy has been observed in canine simultaneous mapping studies. Also, the technique maintains full temporal resolution (RRE <; 0.04) in terms of the activation sequence under various disturbances and in various pathologies such as premature ventricular complex and ventricular tachycardia. Our promising results indicate the excellent performance of noninvasive imaging of cardiac activation under various arrhythmias, and its potential for aiding clinical management of lethal ventricular arrhythmia.

摘要

心血管疾病仍然是全球主要的杀手之一。仅在美国,每年就报告约40万例心脏骤停病例。临床上,射频消融术已广泛应用于室性心律失常的治疗。无创方法已被证明能够提供有关心律失常发生机制的重要信息,并可能有助于临床实践。在这项工作中,我们开发并验证了一种基于时间稀疏性的新型成像方法——心脏电稀疏成像(CESI)。计算机模拟和动物验证结果表明,CESI方法能够通过利用细胞电生理学中的时间稀疏特性,以更高的准确性和鲁棒性进行成像。总体而言,在人体真实模拟中实现了0.8的相关系数、0.2的相对误差和7毫米的定位误差(LE),并且在犬类同步标测研究中观察到了良好的准确性。此外,该技术在各种干扰以及室性早搏和室性心动过速等各种病理情况下,在激活序列方面保持了完整的时间分辨率(相对分辨率误差<0.04)。我们令人鼓舞的结果表明,在各种心律失常情况下,心脏激活的无创成像具有出色的性能,并且其在协助致命性室性心律失常的临床管理方面具有潜力。

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