IEEE Trans Med Imaging. 2021 Aug;40(8):2182-2194. doi: 10.1109/TMI.2021.3073499. Epub 2021 Jul 30.
The Purkinje system is a heart structure responsible for transmitting electrical impulses through the ventricles in a fast and coordinated way to trigger mechanical contraction. Estimating a patient-specific compatible Purkinje Network from an electro-anatomical map is a challenging task, that could help to improve models for electrophysiology simulations or provide aid in therapy planning, such as radiofrequency ablation. In this study, we present a methodology to inversely estimate a Purkinje network from a patient's electro-anatomical map. First, we carry out a simulation study to assess the accuracy of the method for different synthetic Purkinje network morphologies and myocardial junction densities. Second, we estimate the Purkinje network from a set of 28 electro-anatomical maps from patients, obtaining an optimal conduction velocity in the Purkinje network of 1.95 ± 0.25 m/s, together with the location of their Purkinje-myocardial junctions, and Purkinje network structure. Our results showed an average local activation time error of 6.8±2.2 ms in the endocardium. Finally, using the personalized Purkinje network, we obtained correlations higher than 0.85 between simulated and clinical 12-lead ECGs.
浦肯野系统是一种心脏结构，负责通过心室以快速协调的方式传输电脉冲，以引发机械收缩。从电解剖图估计特定于患者的兼容浦肯野网络是一项具有挑战性的任务，它可以帮助改进电生理模拟模型或为治疗计划提供帮助，例如射频消融。在这项研究中，我们提出了一种从患者的电解剖图反演估计浦肯野网络的方法。首先，我们进行了一项模拟研究，以评估该方法对于不同的合成浦肯野网络形态和心肌连接密度的准确性。其次，我们从 28 名患者的一组电解剖图中估计了浦肯野网络，得到浦肯野网络中的最佳传导速度为 1.95±0.25m/s，以及浦肯野-心肌连接的位置和浦肯野网络结构。我们的结果显示，心内膜的平均局部激活时间误差为 6.8±2.2ms。最后，使用个性化的浦肯野网络，我们在模拟和临床 12 导联 ECG 之间获得了高于 0.85 的相关性。
