A Simulation Study Applied to Evaluation of Body Surface Potential Mapping in Ventricular Ectopic Pacemaker Separation and Influence of Lead Density
Hu Xiaogang1, Li Xinya2, Peng Yi2#*
1(School of Electrical Engineering, Beijing Jitotong University, Beijing 100044, China) 2(Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China)
Abstract:Based on our constructed whole heart electrophysiological model, a simulation study was performed to evaluate body surface potential mapping (BSPM) in the ventricular ectopic pacemaker separation and the influence of lead density. 24 ventricular ectopic pacemakers were selected located in the area of the Purkinje fibers, among them 18 in a horizontal ventricular section within the region of 12.5 mm×16 mm and 6 in a vertical line with the length of 7.5 mm. For each ectopic pacemaker in the same region, correlation coefficients of QRS integral map of BSPM (BSPMQRS ) between itself and every other ones were calculated. The two selected ventricular ectopic pacemakers were considered to be separable if the correlation coefficient was less than a threshold of 0.95. Lead density was reduced by evenly deleting the columns or rows in the lead array under the condition that the remaining leads covering the same area as the original ones. Using the method of statistical inverse deduction, the values of the whole leads were estimated based on the potentials on the leads with lower density. And the correlation coefficients between the estimated potentials and the simulated ones were calculated. The resolutions for ventricular ectopic pacemaker separation with lower lead density were evaluated as well. Results showed that the resolution for horizontal ventricular section was (2.80±0.62) mm. And the resolution for the vertical line was (3.25±0.39) mm. When the lead numbers were changed from the original 252 to 132, 72 and 36, the correlation coefficients of the estimated potentials and the simulated ones were 0.987±0.050,0.946±0.060 and 0.852±0.080, respectively. At the same time, resolution of separating ventricular ectopic pacemakers decreased with the reduction of lead density. In addition to proving the validation of our constructed model, the usability tests provide delighting information about the influence of lead density on the performance of BSPM.
胡小刚, 李心雅, 彭屹. 体表电位标测图进行心室异位起搏点定位之分辨率及导联密度影响的仿真研究[J]. 中国生物医学工程学报, 2016, 35(3): 310-316.
Hu Xiaogang, Li Xinya, Peng Yi. A Simulation Study Applied to Evaluation of Body Surface Potential Mapping in Ventricular Ectopic Pacemaker Separation and Influence of Lead Density. Chinese Journal of Biomedical Engineering, 2016, 35(3): 310-316.
[1] Mozaffarian D, Benjamin EJ, Go AS, et al. Heart disease and stroke statistics-2016 update a report from the American Heart Association [EB/OL]. http://circ.ahajournals.org/content/early/2015/12/16/ CIR. 0000000000000350.full.pdf, 2015-12-16/ 2016-02-01. [2] Lux RL, Kornreich Fred. Crossroads in electrocardiographic lead development: a roadmap to the future of electrocardiographic leads in clinical electrocardiography [J]. J Electrocardiol, 2008, 41:183-186. [3] Li G, He B. Localization of the site of origin of cardiac activation by means of a heart-model-based electrocardiographic imaging approach [J]. IEEE Trans Biomed Eng, 2001, 48:660-669. [4] Bonizzi P, Maria de la Salaud AM, Climent JM, et al. Noninvasive assessment of the complexity and stationarity of the atrial wavefront patterns during atrial fibrillation [J]. IEEE Trans Biomed Eng, 2010, 57:2147-2156. [5] 赵洪东. 心电体表地形图系统简介及其在急性缺血性心血管疾病诊断中的应用 [J]. 中国全科医学,2013,16(10B):3515-3518. [6] Horácˇek BM, Wang L, Dawoud F.et al. Noninvasive electrocardiographic imaging of chronic myocardial infarct scar [J]. J Electrocardiol, 2015, 48:952-958. [7] 姚焰,王方正.心脏电生理学概念:心内多导联标测技术的进展[J].中国循环杂志, 2001, 16(2):85-86. [8] Shannon HJ, Navarro CO, Smith BA, et al. Activation patterns during selective pacing of the left ventricle can be characterized using noninvasive electrocardiographic imaging[J]. Journal of Electrocardiology, 2007, 40:111-117. [9] 李心雅 许亮 杨啸林,等. 全心电生理建模及体表电位标测图的仿真 [J]. 中国生物医学工程学报,2011,30(2):240-249. [10] Hren R, Punske BB. A comparison of simulated QRS isointegral maps resulting from pacing at adjacent Sites [J]. Journal of Electrocardiologye,1998,31:135-144. [11] Ichihara Y, Hayashi H, Tomita Y, et al. Small differences among body surface and epicardial QRST integral maps recorded during normal activation and experimentally simulated left bundle branch block or preexcitation in canine hearts [J]. J Electrocardiol, 1992,25(4):315-322. [12] Hren R, Stroink G, Horacek BM,et al. Spatial resolution of body surface potential maps and magnetic field maps: A simulation study applied to the identification of ventricular pre-excitation sites [J]. Med Biol Eng Comput,1998, 36:145-157. [13] Li G, Lian J, He B. Spatial resolution of body surface potential and laplacian pace mapping [J]. J Pacing and Clin Electrophysiology ,2002, 25(4):420-429. [14] Kuenzler RO, MacLeod RS, Taccardi B, et al. Estimation of epicardial activation mapsfrom intravascular recordings [J]. Journal of Electrocardiology,1999, 32:77-92. [15] Zimmer JE, Hynynen K, He DS, et al. The feasibility of using ultrasound for cardiac ablation [J]. IEEE Trans Biomed Eng, 1995, 42: 891-897. [16] Strickberger SA, Tokano T, Kluiwstra JUA, et al. Extracardiac ablation of the canine atrioventricular junction by use of high-intensity focused ultrasound [J]. Circulation, 1999, 100: 203-208. [17] Sharma A, Wong D, Weidlich G, et al. Noninvasive stereotactic radiosurgery (CyberHeart) for creation of ablation lesions in the atrium [J]. Heart Rhythm,2010, 7: 802-810. [18] Green LS, Lux RL, Ershler PR, et al. Resolution of pace mapping stimulus site separation using body surface [J]. Circulation,1994, 90:462-470. [19] Ramanathan1 C, Ghanem1 Raja N, Jia1 P, et al. Noninvasive electrocardiographic imaging for cardiac electrophysiology and arrhythmia [J]. Nature Medicine, 2004,10:422-428. [20] Wang Yong, Cuculich PS, Zhang Junjie, et al. Noninvasive electroanatomic mapping of human ventricular arrhythmias with electrocardiographic imaging (ECGI) [J]. Science Translational Medicine, 2011, 3(98): 98ra84.