Sensitivity and Spatial Resolution of Transvenous Leads in Implantable Cardioverter Defibrillator
Sensitivity and Spatial Resolution of Transvenous Leads in Implantable Cardioverter Defibrillator
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DOI：
10.1109/tbme.2009.2027425
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发表时间：
2009-12-01
影响因子：
4.6
通讯作者：
Luis Rojo-Alvarez, Jose
中科院分区：
文献类型：
--
作者：
Requena-Carrion, Jesus;Vaisanen, Juho;Luis Rojo-Alvarez, Jose
先前已有文献记载，植入式心律转复除颤器 (ICD) 中记录的电描记图 (EGM) 的主要特征和传感性能取决于引线配置。尽管这种依赖性归因于铅敏感性和空间分辨率的差异，但尚未尝试对 ICD 上的这两个特性进行量化。本文提出了研究 ICD 经静脉导线空间分辨率的操作框架。我们建议根据称为导联分辨率体积 (ResV) 的新表征来量化 ICD 经静脉导联的空间分辨率。我们分析了两种单极（尖端罐和线圈罐）和两种双极（真实或尖端环和集成或尖端线圈）ICD 经静脉导线配置的灵敏度分布和 ResV。基于可见人类数据集的详细人体胸部 3D 模型用于计算导联灵敏度，并使用简单心脏动力学的计算机模拟来量化 ResV。对于每种导联配置，观察到整个心室心肌 (VM) 的敏感性分布差异。在我们的人体胸部计算机模型中，发现 ResV 分别占真双极、集成双极、尖端单极和线圈单极 ICD 导联 VM 的 7%、35%、45% 和 70%。此外，我们的分析表明，空间分辨率取决于导联灵敏度和心脏动力学，因此，它可能会因不同的心律而异。
It has been previously documented that the main features and sensing performance of electrograms (EGMs) recorded in implantable cardioverter defibrillators (ICDs) depend on lead configuration. Although this dependence has been ascribed to differences in lead sensitivity and spatial resolution, the quantification of these two properties on ICD has not yet been attempted. In this paper, an operative framework to study the spatial resolution of ICD transvenous leads is presented. We propose to quantify the spatial resolution of ICD transvenous leads based on a new characterization called lead resolution volume (ResV). We analyzed the sensitivity distribution and the ResV of two unipolar (tip-can and coil-can) and two bipolar (true or tip-ring and integrated or tip-coil) ICD transvenous lead configurations. A detailed 3-D model of the human thorax based on the visible human man dataset was used to compute the lead sensitivity and computer simulations of simple cardiac dynamics were used to quantify the ResV. Differences in the sensitivity distribution throughout the ventricular myocardium (VM) were observed for each lead configuration. In our computer model of the human thorax, the ResV was found to comprise 7%, 35%, 45%, and 70% of the VM for true bipolar, integrated bipolar, tip-can unipolar, and coil-can unipolar ICD leads, respectively. Furthermore, our analysis shows that the spatial resolution depends on both lead sensitivity and cardiac dynamics, and therefore, it can vary for different heart rhythms.