scholarly journals Prospective Assessment of an Automated Intraprocedural 12-Lead ECG-Based System for Localization of Early Left Ventricular Activation

2020 ◽  
Vol 13 (7) ◽  
Author(s):  
Shijie Zhou ◽  
Amir AbdelWahab ◽  
B. Milan Horáček ◽  
Paul J. MacInnis ◽  
James W. Warren ◽  
...  
Keyword(s):  
Population Based ◽  
Left Ventricular ◽  
Specific Site ◽  
Patient Specific ◽  
Localization Error ◽  
Localization Accuracy ◽  
Localization System ◽  
Contact Mapping ◽  
Ventricular Activation ◽  
Site Localization

Background: To facilitate ablation of ventricular tachycardia (VT), an automated localization system to identify the site of origin of left ventricular activation in real time using the 12-lead ECG was developed. The objective of this study was to prospectively assess its accuracy. Methods: The automated site of origin localization system consists of 3 steps: (1) localization of ventricular segment based on population templates, (2) population-based localization within a segment, and (3) patient-specific site localization. Localization error was assessed by the distance between the known reference site and the estimated site. Results: In 19 patients undergoing 21 catheter ablation procedures of scar-related VT, site of origin localization accuracy was estimated using 552 left ventricular endocardial pacing sites pooled together and 25 VT-exit sites identified by contact mapping. For the 25 VT-exit sites, localization error of the population-based localization steps was within 10 mm. Patient-specific site localization achieved accuracy of within 3.5 mm after including up to 11 pacing (training) sites. Using 3 remotes (67.8±17.0 mm from the reference VT-exit site), and then 5 close pacing sites, resulted in localization error of 7.2±4.1 mm for the 25 identified VT-exit sites. In 2 emulated clinical procedure with 2 induced VTs, the site of origin localization system achieved accuracy within 4 mm. Conclusions: In this prospective validation study, the automated localization system achieved estimated accuracy within 10 mm and could thus provide clinical utility.

68 EFFECTS OF PACING SITE ON LEFT VENTRICULAR ACTIVATION SEQUENCES USING A NON-CONTACT MAPPING SYSTEM: IMPLICATIONS FOR HEART FAILURE PACING.

2004 ◽  
Vol 52 (Suppl 2) ◽  
pp. S357.3-S357
Author(s):  
D. Xing ◽  
F. G. Devecchi ◽  
T. R. Staley ◽  
D. S. Glassman ◽  
J. B. Martins
Keyword(s):  
Heart Failure ◽  
Left Ventricular ◽  
Contact Mapping ◽  
Mapping System ◽  
Ventricular Activation

scholarly journals AUTOMATED LOCALIZATION SYSTEM FOR LOCALIZATION OF VENTRICULAR ACTIVATION ORIGIN BASED PATIENT-SPECIFIC CT IMAGING

2019 ◽  
Vol 35 (10) ◽  
pp. S82
Author(s):  
S. Zhou ◽  
J. Sapp ◽  
B. Horacek ◽  
J. Davis ◽  
R. Parkash ◽  
...  
Keyword(s):  
Ct Imaging ◽  
Patient Specific ◽  
Localization System ◽  
Ventricular Activation

scholarly journals Assessment of an ECG‐Based System for Localizing Ventricular Arrhythmias in Patients With Structural Heart Disease

2021 ◽  
Author(s):  
Shijie Zhou ◽  
Amir AbdelWahab ◽  
John L. Sapp ◽  
Eric Sung ◽  
Konstantinos N. Aronis ◽  
...  
Keyword(s):  
Heart Disease ◽  
Case Series ◽  
Premature Ventricular Contraction ◽  
Structural Heart Disease ◽  
Patient Specific ◽  
Localization Error ◽  
Localization Accuracy ◽  
Accurate Localization ◽  
Prospective Case Series ◽  
Pace Mapping

Background We have previously developed an intraprocedural automatic arrhythmia‐origin localization (AAOL) system to identify idiopathic ventricular arrhythmia origins in real time using a 3‐lead ECG. The objective was to assess the localization accuracy of ventricular tachycardia (VT) exit and premature ventricular contraction (PVC) origin sites in patients with structural heart disease using the AAOL system. Methods and Results In retrospective and prospective case series studies, a total of 42 patients who underwent VT/PVC ablation in the setting of structural heart disease were recruited at 2 different centers. The AAOL system combines 120‐ms QRS integrals of 3 leads (III, V2, V6) with pace mapping to predict VT exit/PVC origin site and projects that site onto the patient‐specific electroanatomic mapping surface. VT exit/PVC origin sites were clinically identified by activation mapping and/or pace mapping. The localization error of the VT exit/PVC origin site was assessed by the distance between the clinically identified site and the estimated site. In the retrospective study of 19 patients with structural heart disease, the AAOL system achieved a mean localization accuracy of 6.5±2.6 mm for 25 induced VTs. In the prospective study with 23 patients, mean localization accuracy was 5.9±2.6 mm for 26 VT exit and PVC origin sites. There was no difference in mean localization error in epicardial sites compared with endocardial sites using the AAOL system (6.0 versus 5.8 mm, P =0.895). Conclusions The AAOL system achieved accurate localization of VT exit/PVC origin sites in patients with structural heart disease; its performance is superior to current systems, and thus, it promises to have potential clinical utility.

Abstract 13184: A New Intraprocedural Automated System for Localizing Idiopathic Ventricular Arrhythmia Origin Sites

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Shijie Zhou ◽  
Amir AbdelWahab ◽  
John L Sapp ◽  
Eric Sung ◽  
Konstantinos Aronis ◽  
...  
Keyword(s):  
Ventricular Arrhythmia ◽  
Automated System ◽  
Patient Specific ◽  
Localization Accuracy ◽  
Accurate Localization ◽  
Ventricular Activation ◽  
Specific Geometry ◽  
Pace Mapping ◽  
Activation Mapping ◽  
Better Than

Introduction: Few intraprocedural localization systems have been developed to predict idiopathic ventricular arrhythmia (IVA) source sites. However, an accurate and bi-ventricular patient-specific automated site of origin localization system remains elusive. To address this issue, we have developed a new automatic arrhythmia origin localization (AAOL) system that determines the sites of earliest activation in both ventricles and provides superior accuracy. Hypothesis: We hypothesized that the AAOL system can use electroanatomic mapping (EAM) geometry and accurately localize IVA source sites on patient-specific geometry of LV, RV and neighboring vessels using 3-lead ECGs. Methods: Twenty patients undergoing IVA catheter ablation had a 12-lead ECG recorded during clinical arrhythmia and during pacing at various locations identified on EAM geometries. The AAOL system combined 3-lead (III, V2, V6) 120-ms QRS integrals and patient-specific EAM geometry with intracardiac pacing to predict the site of earliest ventricular activation. The predicted site was projected onto the EAM geometry using the EAM triangular-mesh site nearest to the tip of the predicted site. Results: Twenty-three IVA source sites were clinically identified by activation mapping and/or pace mapping (8 RV, 15 LV, including 8 from the posteromedial papillary muscle; 2 from the aortic root; and 1 from the distal coronary sinus). The new system achieved a mean localization accuracy of 3.6 mm for the 23 mapped IVAs (Figure 1D), better than that achieved by previous systems. Conclusions: The new AAOL system offers highly accurate localization of IVA source sites in both ventricles and neighboring vessels, which could facilitate ablation procedures for patients with IVAs.

scholarly journals Reconstruction of three-dimensional biventricular activation based on the 12-lead electrocardiogram via patient-specific modelling

EP Europace ◽  
2020 ◽  
Author(s):  
Simone Pezzuto ◽  
Frits W Prinzen ◽  
Mark Potse ◽  
Francesco Maffessanti ◽  
François Regoli ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Three Dimensional ◽  
Specific Model ◽  
Left Ventricular ◽  
Propagation Model ◽  
Electrical Activation ◽  
Patient Specific ◽  
Non Invasive ◽  
Ventricular Activation ◽  
Potential Applications

Abstract Aims Non-invasive imaging of electrical activation requires high-density body surface potential mapping. The nine electrodes of the 12-lead electrocardiogram (ECG) are insufficient for a reliable reconstruction with standard inverse methods. Patient-specific modelling may offer an alternative route to physiologically constraint the reconstruction. The aim of the study was to assess the feasibility of reconstructing the fully 3D electrical activation map of the ventricles from the 12-lead ECG and cardiovascular magnetic resonance (CMR). Methods and results Ventricular activation was estimated by iteratively optimizing the parameters (conduction velocity and sites of earliest activation) of a patient-specific model to fit the simulated to the recorded ECG. Chest and cardiac anatomy of 11 patients (QRS duration 126–180 ms, documented scar in two) were segmented from CMR images. Scar presence was assessed by magnetic resonance (MR) contrast enhancement. Activation sequences were modelled with a physiologically based propagation model and ECGs with lead field theory. Validation was performed by comparing reconstructed activation maps with those acquired by invasive electroanatomical mapping of coronary sinus/veins (CS) and right ventricular (RV) and left ventricular (LV) endocardium. The QRS complex was correctly reproduced by the model (Pearson’s correlation r = 0.923). Reconstructions accurately located the earliest and latest activated LV regions (median barycentre distance 8.2 mm, IQR 8.8 mm). Correlation of simulated with recorded activation time was very good at LV endocardium (r = 0.83) and good at CS (r = 0.68) and RV endocardium (r = 0.58). Conclusion Non-invasive assessment of biventricular 3D activation using the 12-lead ECG and MR imaging is feasible. Potential applications include patient-specific modelling and pre-/per-procedural evaluation of ventricular activation.

Cardiac Resynchronisation Therapy – Evolving Strategies to Enhance Response

2010 ◽  
Vol 6 (1) ◽  
pp. 83
Author(s):  
Jagmeet P Singh ◽  
Keyword(s):  
Heart Failure ◽  
Systolic Heart Failure ◽  
Cardiac Resynchronisation Therapy ◽  
Left Ventricular ◽  
Patient Specific ◽  
Cardiac Resynchronisation ◽  
Clinical Benefits ◽  
Pacing Lead ◽  
Resynchronisation Therapy ◽  
Physiological Impact

Cardiac resynchronisation therapy (CRT) has gained widespread acceptance as a safe and effective therapeutic strategy for congestive heart failure (CHF) refractory to optimal medical therapy. The use of implantable devices has substantially altered the natural history of systolic heart failure. These devices exert their physiological impact through ventricular remodelling, associated with a reduction in left ventricular (LV) volumes and an improvement in ejection fraction (EF). Several prospective randomised studies have shown that this in turn translates into long-term clinical benefits such as improved quality of life, increased functional capacity and reduction in hospitalisation for heart failure and overall mortality. Despite these obvious benefits, there remain more than a few unresolved concerns, the most important being that up to one-third of patients treated with CRT do not derive any detectable benefit. There are several determinants of successful delivery and response to CRT, including selecting the appropriate patient, patient-specific optimal LV pacing lead placement and appropriate post-implant device care and follow-up. This article highlights the importance of collectively working on all of these aspects of CRT to enhance and maximise response.

A Comparative Study of Computational Intelligence Algorithms for Sensor Localization

2019 ◽  
Vol 9 (2) ◽  
pp. 224-236
Author(s):  
Vaishali R. Kulkarni ◽  
Veena Desai ◽  
Raghavendra Kulkarni
Keyword(s):  
Firefly Algorithm ◽  
Heuristic Algorithms ◽  
Computing Time ◽  
Sensor Nodes ◽  
Convergence Time ◽  
Localization Error ◽  
Location Awareness ◽  
Cultural Algorithm ◽  
Localization Accuracy ◽  
Multi Stage

Background & Objective: Location of sensors is an important information in wireless sensor networks for monitoring, tracking and surveillance applications. The accurate and quick estimation of the location of sensor nodes plays an important role. Localization refers to creating location awareness for as many sensor nodes as possible. Multi-stage localization of sensor nodes using bio-inspired, heuristic algorithms is the central theme of this paper. Methodology: Biologically inspired heuristic algorithms offer the advantages of simplicity, resourceefficiency and speed. Four such algorithms have been evaluated in this paper for distributed localization of sensor nodes. Two evolutionary computation-based algorithms, namely cultural algorithm and the genetic algorithm, have been presented to optimize the localization process for minimizing the localization error. The results of these algorithms have been compared with those of swarm intelligence- based optimization algorithms, namely the firefly algorithm and the bee algorithm. Simulation results and analysis of stage-wise localization in terms of number of localized nodes, computing time and accuracy have been presented. The tradeoff between localization accuracy and speed has been investigated. Results: The comparative analysis shows that the firefly algorithm performs the localization in the most accurate manner but takes longest convergence time. Conclusion: Further, the cultural algorithm performs the localization in a very quick time; but, results in high localization error.

scholarly journals The effect of beta-blockers on hemodynamic parameters in patient-specific blood flow simulations of type-B aortic dissection: a virtual study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Mohammad Amin Abazari ◽  
Deniz Rafieianzab ◽  
M. Soltani ◽  
Mona Alimohammadi
Keyword(s):  
Aortic Dissection ◽  
Clinical Decision Making ◽  
Beta Blockers ◽  
False Lumen ◽  
Specific Treatment ◽  
Left Ventricular ◽  
Patient Specific ◽  
Type B ◽  
Windkessel Model ◽  
Computed Tomography Images

AbstractAortic dissection (AD) is one of the fatal and complex conditions. Since there is a lack of a specific treatment guideline for type-B AD, a better understanding of patient-specific hemodynamics and therapy outcomes can potentially control the progression of the disease and aid in the clinical decision-making process. In this work, a patient-specific geometry of type-B AD is reconstructed from computed tomography images, and a numerical simulation using personalised computational fluid dynamics (CFD) with three-element Windkessel model boundary condition at each outlet is implemented. According to the physiological response of beta-blockers to the reduction of left ventricular contractions, three case studies with different heart rates are created. Several hemodynamic features, including time-averaged wall shear stress (TAWSS), highly oscillatory, low magnitude shear (HOLMES), and flow pattern are investigated and compared between each case. Results show that decreasing TAWSS, which is caused by the reduction of the velocity gradient, prevents vessel wall at entry tear from rupture. Additionally, with the increase in HOLMES value at distal false lumen, calcification and plaque formation in the moderate and regular-heart rate cases are successfully controlled. This work demonstrates how CFD methods with non-invasive hemodynamic metrics can be developed to predict the hemodynamic changes before medication or other invasive operations. These consequences can be a powerful framework for clinicians and surgical communities to improve their diagnostic and pre-procedural planning.

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