NDLI: On the efficiency and accuracy of the single equivalent moving dipole method to identify sites of cardiac electrical activation

Content Provider	Springer Nature Link
Author	Sohn, Kwanghyun Armoundas, Antonis A.
Copyright Year	2016
Abstract	We have proposed an algorithm to guide radiofrequency catheter ablation procedures. This algorithm employs the single equivalent moving dipole (SEMD) to model cardiac electrical activity. The aim of this study is to investigate the optimal time instant during the cardiac cycle as well as the number of beats needed to accurately estimate the location of a pacing site. We have evaluated this algorithm by pacing the ventricular epicardial surface and inversely estimating the locations of pacing electrodes from the recorded body surface potentials. Two pacing electrode arrays were sutured on the right and left ventricular epicardial surfaces in swine. The hearts were paced by the electrodes sequentially at multiple rates (120–220 bpm), and body surface ECG signals from 64 leads were recorded for the SEMD estimation. We evaluated the combined error of the estimated interelectrode distance and SEMD direction at each time instant during the cardiac cycle, and found the error was minimum when the normalized root mean square (RMS $_{ n }$) value of body surface ECG signals reached 15 % of its maximum value. The beat-to-beat variation of the SEMD locations was significantly reduced (p < 0.001) when estimated at 15 % RMS $_{ n }$ compared to the earliest activation time (EAT). In addition, the 5–95 % interval of the estimated interelectrode distance error decreased exponentially as the number of beats used to estimate a median beat increased. When the number of beats was 4 or larger, the 5–95 % interval was smaller than 3.5 mm (the diameter of a commonly used catheter). In conclusion, the optimal time for the SEMD estimation is at 15 % of RMS $_{ n }$, and at that time instant a median beat estimated from 4 beats is associated with a beat-to-beat variability of the SEMD location that is appropriate for catheter ablation procedures.
Starting Page	1611
Ending Page	1619
Page Count	9
File Format	PDF
ISSN	01400118
Journal	Medical and Biological Engineering and Computing
Volume Number	54
Issue Number	10
e-ISSN	17410444
Language	English
Publisher	Springer Berlin Heidelberg
Publisher Date	2016-01-22
Publisher Place	Berlin, Heidelberg
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Catheter ablation Single equivalent moving dipole Noninvasive Localization Arrhythmia Human Physiology Biomedical Engineering Imaging Radiology Computer Applications
Content Type	Text
Resource Type	Article
Subject	Biomedical Engineering Computer Science Applications

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