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Robert S. MacLeod, Yesim Serinagaoglu*, Bulent Yilmaz, and Dana H. Brooks*

Epicardial Mapping from Venous Catheter Measurements, Body Surface Potential Maps, and an Electrocardiographic Inverse Solution. Robert S. MacLeod, Yesim Serinagaoglu*, Bulent Yilmaz, and Dana H. Brooks*. NEH Cardiovascular Research and Training Institute (CVRTI), U of Utah

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Robert S. MacLeod, Yesim Serinagaoglu*, Bulent Yilmaz, and Dana H. Brooks*

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  1. Epicardial Mapping from Venous Catheter Measurements, Body Surface Potential Maps, and an Electrocardiographic Inverse Solution Robert S. MacLeod, Yesim Serinagaoglu*, Bulent Yilmaz, and Dana H. Brooks* NEH Cardiovascular Research and Training Institute (CVRTI), U of Utah *Communications and Digital Signal Processing (CDSP), Northeastern U

  2. Forward Inverse Combining Information Sources

  3. Venous Catheter Based Mapping

  4. Training Data Covariance Matrix Sparse Test Data Estimate = Estimation Matrix * Statistical Estimation

  5. Original Mixed RV-only LV-only Estimated Activation Maps • Training set composition • Lead selection

  6. Forward Inverse Augmented Inverse Problem Torso geometry + Body-Surface Potentials + Sparse Epicardial Potentials + Inverse Solution Epicardial Map

  7. Inverse(Tikhonov) Subtraction Approach Unknown Known 1) Subtract known epicardial potentials 2) Solve reduced inverse problem

  8. Estimation Epicardial Estimation . . . t1 t2 ….. ….tN

  9. Estimation Combined Estimation

  10. (m,s) Inverse(MAP) Bayesian Approach

  11. Inverse(MAP) Hybrid Approach Estimate (m,s)

  12. Tank/Heart Geometry

  13. Test Lead Sets Anterior 42 leads 21 leads 10 leads Posterior

  14. Simulation Study • 490 lead measured sock data • Surrogate catheter potentials • 42 sites • + Gaussian noise • Torso potentials • Calculated noise-free using forward model • + Gaussian noise

  15. Dec 13, 2000 Dec 13, 2000 Leave-One-Experiment Out Protocol Training Data Test Data LV Paced Beats Dec 18, 2000 Mixed Paced Beats

  16. LV Pacing (LV-23 ms) Orig Subt MAP Est Epi Est All Hybrid MAP 31: LV-MEpiP-23 ms

  17. LV Pacing (LV-38 ms) Orig Subt MAP Est Epi Est All Hybrid MAP 31: LV-MEpiP-38 ms

  18. Orig Subt MAP Est Epi Est All Hybrid MAP LV Pacing (LV-47 ms) 31: LV-MEpiP-47 ms

  19. Orig Subt MAP Est Epi Est All Hybrid MAP LV Pacing (Mixed-23 ms) 31: LV-RV-MEpiP-23 ms

  20. Orig Subt MAP Est Epi Est All Hybrid MAP LV Pacing (Mixed-38 ms) 31: LV-RV-MEpiP-38 ms

  21. Orig Subt MAP Est Epi Est All Hybrid MAP LV Pacing (Mixed-47 ms) 31: LV-RV-MEpiP-47 ms

  22. MAP Estim-Epi Estim-All MAP-Hybrid Subtr Relative Error (31-LV) 1.4 1.2 1 Relative Error 0.8 0.6 0.4 0.2 0 0 10 20 30 40 50 60 70 80 90 100 Time [ms]

  23. MAP Estim-Epi Estim-All MAP-Hybrid Subtr Relative Error (31-Mixed) 1.4 1.2 1 Relative Error 0.8 0.6 0.4 0.2 0 0 10 20 30 40 50 60 70 80 90 100 Time [ms]

  24. Estimation Findings • Estimation alone: noisy, unstable results • Estimation + inverse: smoothing improves stability

  25. Inverse Solution Findings • All solutions better than simple Tikhonov • MAP usually improved with addition of catheter measurements (Hybrid MAP)

  26. Role of Statistics (Training) • Generally helps • But can add artifacts, e.g., spurious breakthroughs or wavefronts • Torso potentials can reduce artifacts

  27. … but not always Conclusion More (bigger) is better…..

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