Localization of Activation Origin on Patient-Specific Endocardial Surface by the Equivalent Double Layer (EDL) Source Model with Sparse Bayesian Learning
Abstrakt
Objective: Ablation treatment of ventricular arrhythmias can be facilitated by pre-procedure planning aided by electrocardiographic inverse solution, which can help to localize the origin of arrhythmia. Our aim was to improve localization accuracy of the inverse solution for activation originating on the left-ventricular endocardial surface, by using a sparse Bayesian learning (SBL).
Methods: The inverse problem of electrocardiography was solved by reconstructing endocardial potentials from time-integrals of body-surface electrocardiograms and from patient-specific geometry of the heart and torso for 3 patients with structurally normal ventricular myocardium, who underwent endocardial catheter mapping which included pace-mapping. Complementary simulations using dipole sources in patient-specific geometry were also performed.
The proposed method is using sparse property of the equivalent-double-layer (EDL) model of cardiac sources and employs the SBL and makes use of the spatio-temporal features of the cardiac action potentials. Results: The mean localization error of the proposed method for pooled pacing sites (n = 52) was significantly better (p = 0.0039) than that achieved for the same patients in the previous study.
Simulation experiments localized the source dipoles (n = 48) from forward-simulated potentials with the error of 9.4 x 4.5 mm (mean x SD). Conclusion: The results of our clinical and simulation experiments demonstrate that localization of left-ventricular endocardial activation by means of the Bayesian approach based on sparse representation of sources by EDL is feasible and accurate.
Significance: The proposed approach to localizing endocardial sources may have important applications in pre-procedure assessment of arrhythmias and in guiding their ablation treatment.