Meng Shu, Chamorro-Servent Judit, Sunderland Nicholas, Zhao Jichao, Bear Laura R, Lever Nigel A, Sands Gregory B, LeGrice Ian J, Gillis Anne M, Budgett David M, Smaill Bruce H
Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand.
Department of Mathematics, Universitat Autònoma de Barcelona, Bellaterra, Spain.
Front Physiol. 2022 Jul 7;13:873630. doi: 10.3389/fphys.2022.873630. eCollection 2022.
Atrial fibrillation (AF) is the most common cardiac dysrhythmia and percutaneous catheter ablation is widely used to treat it. Panoramic mapping with multi-electrode catheters has been used to identify ablation targets in persistent AF but is limited by poor contact and inadequate coverage of the left atrial cavity. In this paper, we investigate the accuracy with which atrial endocardial surface potentials can be reconstructed from electrograms recorded with non-contact catheters. An approach was employed in which "ground-truth" surface potentials from experimental contact mapping studies and computer models were compared with inverse potential maps constructed by sampling the corresponding intracardiac field using virtual basket catheters. We demonstrate that it is possible to 1) specify the mixed boundary conditions required for mesh-based formulations of the potential inverse problem fully, and 2) reconstruct accurate inverse potential maps from recordings made with appropriately designed catheters. Accuracy improved when catheter dimensions were increased but was relatively stable when the catheter occupied >30% of atrial cavity volume. Independent of this, the capacity of non-contact catheters to resolve the complex atrial potential fields seen in reentrant atrial arrhythmia depended on the spatial distribution of electrodes on the surface bounding the catheter. Finally, we have shown that reliable inverse potential mapping is possible in near real-time with meshless methods that use the Method of Fundamental Solutions.
心房颤动（AF）是最常见的心脏节律失常，经皮导管消融术被广泛用于治疗该病。多电极导管全景标测已用于确定持续性房颤的消融靶点，但受左心房腔接触不良和覆盖不足的限制。在本文中，我们研究了从非接触导管记录的心电图重建心房内膜表面电位的准确性。采用了一种方法，即将实验性接触标测研究和计算机模型的“真实”表面电位与通过使用虚拟篮状导管对相应心内电场进行采样构建的逆电位图进行比较。我们证明，有可能 1）充分指定基于网格的电位逆问题公式所需的混合边界条件，以及 2）从使用适当设计的导管进行的记录中重建准确的逆电位图。当导管尺寸增加时，准确性提高，但当导管占据心房腔体积的 >30%时，准确性相对稳定。与此无关的是，非接触导管解析折返性房性心律失常中所见复杂心房电位场的能力取决于导管表面电极的空间分布。最后，我们表明，使用基本解方法的无网格方法可以近乎实时地进行可靠的逆电位标测。
