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  • 1
    ISSN: 1540-8167
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Spatial Distribution of the QT Interval. Introduction: The role of QT dispersion as a predictor of arrhythmia vulnerability has not been consistently confirmed in the literature. Therefore, it is important to identify the electrophysiologic mechanisms that affect QT duration and distribution. We compared the spatial distributions of QT intervals (QTI) with potential distributions on cardiac and body surfaces and with recovery times on the cardiac surface. We hypothesized that the measure of QTI is affected by the presence of the zero potential line in the potential distribution, as well as the sequence of recovery. We also investigated use of the STT area as a possible indicator of recovery times on the cardiac surface. Methods and Results: High-resolution spatial distributions of QTI and potentials were determined on the body surface of human subjects and on the surface of a torso-shaped tank containing an isolated canine heart. Additionally, spatial distributions of QTI, recovery times, and STT areas were determined on the surface of exposed canine hearts. Unipolar electrograms were recorded during atrial and ventricular pacing for normal hearts and cases of myocardial infarction. Regions of shortest QTI always coincided with the location of the zero potential line on the cardiac and body surfaces. On the cardiac surface, in regions away from the zero line, similarities were observed between the patterns of QTI and the sequence of recovery. STT areas and recovery times were highly correlated on the cardiac surface. Conclusion: QTI is not a robust index of local recovery time on the cardiac surface. QTI distributions were affected by the position of the zero potential line, which is unrelated to local recovery times. However, similarities in the patterns of QTI and recovery times in some regions may help explain the frequently reported predictive value of QT dispersion. Preliminary results indicate STT area may be a better index of recovery time and recovery time dispersion on the epicardium than QTI.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Journal of cardiovascular electrophysiology 9 (1998), S. 0 
    ISSN: 1540-8167
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Useful Lessons from Body Surface Mapping. Body surface potential maps (BSMs) depict the time varying distribution of cardiac potentials on the entire surface of the torso. Hundreds of studies have shown that BSMs contain more diagnostic and prognostic information than can he elicited from the 12-lead ECG. Despite these advantages, body surface mapping has not become a routinely used clinical method. One reason is that visual examination and sophisticated analysis of BSMs do not permit inferring the sequence of excitation and repolarization in the heart with a sufficient degree of certainty and detail. These limitations can be partially overcome by implementing inverse procedures that reconstruct epicardial potentials, isochrones, and ECGs from body surface measurements. Furthermore, ongoing experimental work and simulation studies show that a great deal of information about intramural events can he elicited from measured or reconstructed epicardial potential distributions. Interpreting epicardial data in terms of deep activity requires extensive knowledge of the architecture of myocardial fibers, their anisotropic properties, and the role of rotational anisotropy in affecting propagation and the associated potential fields.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Journal of cardiovascular electrophysiology 6 (1995), S. 0 
    ISSN: 1540-8167
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Localization of Ischemia. This study demonstrates the utility of an electrocardiographic Localization of Ischemia. This study demonstrates the utility of an electrocardiographic Inverse solution, coupled with body surface potential mapping (BSPM), in localizing acute ischemia in patients undergoing percutaneous transluminal coronary angioplasty (PTCA). PTCA balloon inflations produce complete occlusion and acute transient ischemia, which can be detected electrocardiographically with BSPM. Comparisons between maps recorded both during and before the inflation of the PTCA balloon allow patient- and artery-specific characterizations of the resulting ischemia. Knowledge of the patient's coronary anatomy and the location of the occlusion site by coronary angiography permit an estimation based on cardiac hemodynamics of the region of myocardium most likely to suffer from PTCA-induced ischemia. Electrocardiographic inverse solutions provide a means of predicting cardiac potentials from body surface maps. In this study, we describe an inverse solution we have developed to localize the transient ischemia produced by PTCA. To validate the procedure, we compared the locations of predicted ischemia in seven patients with a qualitative estimate of the perfusion region based on fluoroscopic examination of each patient's coronary anatomy and PTCA balloon location. In each case, the region of ischemia predicted by the model included the perfusion zone determined fluoroscopically. These results suggest that electrical changes induced by acute ischemia can be localized with an electrocardiographic inverse solution.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Annals of biomedical engineering 27 (1999), S. 617-626 
    ISSN: 1573-9686
    Keywords: Activation ; Cardiac mapping ; Interpolation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Technology
    Notes: Abstract Interpolation plays an important role in analyzing or visualizing any scalar field because it provides a means to estimate field values between measured sites. A specific example is the measurement of the electrical activity of the heart, either on its surface or within the muscle, a technique known as cardiac mapping, which is widely used in research. While three-dimensional measurement of cardiac fields by means of multielectrode needles is relatively common, the interpolation methods used to analyze these measurements have rarely been studied systematically. The present study addressed this need by applying three trivariate techniques to cardiac mapping and evaluating their accuracy in estimating activation times at unmeasured locations. The techniques were tetrahedron-based linear interpolation, Hardy's interpolation, and least-square quadratic approximation. The test conditions included activation times from both high-resolution simulations and measurements from canine experiments. All three techniques performed satisfactorily at measurement spacing ⩽ 2mm. At the larger interelectrode spacings typical in cardiac mapping (1 cm), Hardy's interpolation proved superior both in terms of statistical measures and qualitative reconstruction of field details. This paper provides extensive comparisons among the methods and descriptions of expected errors for each method at a variety of sampling intervals and conditions. © 1999 Biomedical Engineering Society. PAC99: 8719Nn, 0260Ed, 8719Ff
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Annals of biomedical engineering 26 (1998), S. 278-292 
    ISSN: 1573-9686
    Keywords: Inverse problem of electrocardiography ; Convex optimization ; Multiple constraints ; Set theoretic estimation ; Regularization ; Inverse electrocardiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Technology
    Notes: Abstract The goal of the inverse problem of electrocardiography is noninvasive discrimination and characterization of normal/abnormal cardiac electrical activity from measurements of body surface potentials. Smoothing and attenuation in the torso volume conductor cause the problem to be ill posed. Standard regularized solutions employ an a priori constraint to achieve reliability and may be biased by the constraint chosen as well as the regularization parameter used to weight it. In this paper, we describe an approach that reformulates this inverse problem as the search for a solution that is a member of an admissible solution set; admissibility is defined in terms of the available constraints. In principle, this approach can utilize as many constraints as may be available, unlike standard techniques which do not easily permit the use of multiple constraints. No regularization parameter is required; instead, we need to choose the nature and size of the constraint sets. Constraints described include several spatial constraints, weighted constraints, and temporal constraints. We describe a solution approach based on iterative convex optimization, and the algorithm—the ellipsoid algorithm—which we have used. Accuracy and feasibility of the method are illustrated with simulation results using dipole sources and measured epicardial potentials. © 1998 Biomedical Engineering Society. PAC98: 8710+e, 0260Pn
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Annals of biomedical engineering 26 (1998), S. 597-607 
    ISSN: 1573-9686
    Keywords: Electrocardiography ; Cardiac mapping ; Activation ; Electric potential fields ; Excitation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Technology
    Notes: Abstract In mapping the electrical activity of the heart, interpolation of electric potentials plays two important roles. First, it permits the estimation of potentials in regions that could not be sampled or where signal quality was poor, and second, it supports the construction of isopotential lines and surfaces for visualization. The difficulty in developing robust interpolation techniques for cardiac applications lies in the abrupt change in potential in the vicinity of the activation wave front. Despite the resulting nonlinearities in spatial potential distributions, simple linear interpolation methods are the current standard and the resulting errors due to aliasing can be large if electrode spacing does not lie on the order of 0.5–2 mm—the thickness of the activation wave front. We have developed a novel interpolation method that is based on two observations specific to the spread of excitation in the heart: (1) that propagation velocity changes smoothly within a region large enough to contain several measurement electrodes and (2) that electrogram morphology varies very little in the neighborhood of each sample point except for a time shift in the potential wave forms. The resulting interpolation scheme breaks the interpolation of one highly nonlinear variable—extracellular potential—into two separate interpolations of variables with much less drastic spatial variation—activation time and electrogram morphology. We have applied this method to potentials originally recorded at 1.5 mm spacing and then subsampled at a range of densities for testing of the interpolation. The results based both on reconstruction of isopotential contour maps and statistical comparison showed significant improvement of this novel approach over standard linear techniques. The applications of the new method include improved determination of electrophysiological parameters such as spatial gradients of potential and the path of cardiac activation and recovery, estimation of electrograms at desired locations, and visualization of electric potential distributions. © 1998 Biomedical Engineering Society. PAC98: 8790+y, 0260Ed, 8710+e
    Type of Medium: Electronic Resource
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