Department of Cardiology, Division Heart & Lungs, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
Electrical and Computer Engineering, Northeastern University, Boston, MA, 02115, USA.
Comput Biol Med. 2022 Feb;141:105128. doi: 10.1016/j.compbiomed.2021.105128. Epub 2021 Dec 11.
The standard 12-lead electrocardiogram (ECG) is a diagnostic tool to asses cardiac electrical activity. The vectorcardiogram is a related tool that represents that activity as the direction of a vector. In this work we investigate CineECG, a new 12-lead ECG based analysis method designed to directly estimate the average cardiac anatomical location of activation over time. We describe CineECG calculation and a novel comparison parameter, the average isochrone position (AIP). In a model study, fourteen different activation sequences were simulated and corresponding 12-lead ECGs were computed. The CineECG was compared to AIP in terms of location and direction. In addition, 67-lead body surface potential maps from ten patients were used to study the sensitivity of CineECG to electrode mispositioning and anatomical model selection. Epicardial activation maps from four patients were used for further evaluation. The average distance between CineECG and AIP across the fourteen sequences was 23.7 ± 2.4 mm, with significantly better agreement in the terminal (27.3 ± 5.7 mm) versus the initial QRS segment (34.2 ± 6.1 mm). Up to four cm variation in electrode positioning produced an average distance of 6.5 ± 4.5 mm between CineECG trajectories, while substituting a generic heart/torso model for a patient-specific one produced an average difference of 6.1 ± 4.8 mm. Dominant epicardial activation map features were recovered. Qualitatively, CineECG captured significant features of activation sequences and was robust to electrode misplacement. CineECG provides a realistic representation of the average cardiac activation in normal and diseased hearts. In particular, the terminal segment of the CineECG might be useful to detect pathology.
标准的 12 导联心电图（ECG）是评估心脏电活动的诊断工具。向量心电图是一种相关的工具，它将活动表示为一个向量的方向。在这项工作中，我们研究了 CineECG，这是一种新的基于 12 导联 ECG 的分析方法，旨在直接估计随时间变化的激活的平均心脏解剖位置。我们描述了 CineECG 的计算和一个新的比较参数，即平均等时位置（AIP）。在模型研究中，模拟了十四种不同的激活序列，并计算了相应的 12 导联 ECG。CineECG 在位置和方向上与 AIP 进行了比较。此外，还使用来自十个患者的 67 导联体表电位图来研究 CineECG 对电极定位和解剖模型选择的敏感性。还使用来自四个患者的心外膜激活图进行了进一步评估。十四种序列中 CineECG 和 AIP 之间的平均距离为 23.7±2.4mm，在终末（27.3±5.7mm）与初始 QRS 段（34.2±6.1mm）相比，一致性更好。电极定位的最大 4cm 变化产生了 6.5±4.5mm 的 CineECG 轨迹之间的平均距离，而替代患者特定的心脏/胸廓模型产生了 6.1±4.8mm 的平均差异。恢复了主导心外膜激活图特征。定性地，CineECG 捕捉到了激活序列的重要特征，并且对电极错位具有鲁棒性。CineECG 提供了正常和患病心脏中平均心脏激活的真实表示。特别是，CineECG 的末端段可能有助于检测病理学。
