Electrocardiographic Imaging for Atrial Fibrillation: A Perspective From Computer Models and Animal Experiments to Clinical Value.
Electrocardiographic Imaging for Atrial Fibrillation: A Perspective From Computer Models and Animal Experiments to Clinical Value.
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DOI：
10.3389/fphys.2021.653013
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发表时间：
2021
影响因子：
4
通讯作者：
Bonizzi P
中科院分区：
文献类型：
--
作者：
Salinet J;Molero R;Schlindwein FS;Karel J;Rodrigo M;Rojo-Álvarez JL;Berenfeld O;Climent AM;Zenger B;Vanheusden F;Paredes JGS;MacLeod R;Atienza F;Guillem MS;Cluitmans M;Bonizzi P
心电成像(ECGI)是一种根据体表电位记录和心脏和躯干的几何信息无创重建心脏表面电活动的技术。ECGI用于房性和室性心律失常的诊断和治疗，已显示出科学和临床价值。对于心房颤动(房颤)，由于疾病及其表现的进行性和异质性，心房的小体积和壁厚，以及微结构异常在房颤中的相对较大作用，对有利于房颤的电传播和基础底物的表征固有地比室性心律失常更具挑战性。与此同时，与其他标测技术相比，ECGI具有优势，可以无创地对每一次心房搏动时的心房电活动进行全球表征。然而，由于ECGI是耗时和昂贵的，使用电标测来指导房颤消融仍未完全确立，ECGI治疗房颤的临床价值仍在评估中。尽管如此，已知的房颤是电和结构异常之间复杂相互作用的表现，因此，真正的解剖结构成像可能阐明房颤发生、进展和治疗的重要关键因素。因此，当涉及到房颤的特征和治疗时，确定ECGI可以成功地解决哪些临床问题，以及哪些问题可能超出其技术限制是至关重要的。在这篇手稿中，我们回顾了研究人员试图解决的关于ECGI用于房颤特征和治疗指导的问题(例如，房颤触发因素和维持机制的定位)，并讨论了技术要求和验证。我们解决了实验和临床结果、局限性和未来的挑战，以有效地应用ECGI来了解和管理房颤。我们关注现有的技术和临床应用，关注计算机模型和(动物或人体)实验，关注方法学和临床验证的挑战。这项研究的总体目标是就ECGI研究可能采取的有价值的方向达成共识，以提供未来房颤特征和治疗指导的改进。
Electrocardiographic imaging (ECGI) is a technique to reconstruct non-invasively the electrical activity on the heart surface from body-surface potential recordings and geometric information of the torso and the heart. ECGI has shown scientific and clinical value when used to characterize and treat both atrial and ventricular arrhythmias. Regarding atrial fibrillation (AF), the characterization of the electrical propagation and the underlying substrate favoring AF is inherently more challenging than for ventricular arrhythmias, due to the progressive and heterogeneous nature of the disease and its manifestation, the small volume and wall thickness of the atria, and the relatively large role of microstructural abnormalities in AF. At the same time, ECGI has the advantage over other mapping technologies of allowing a global characterization of atrial electrical activity at every atrial beat and non-invasively. However, since ECGI is time-consuming and costly and the use of electrical mapping to guide AF ablation is still not fully established, the clinical value of ECGI for AF is still under assessment. Nonetheless, AF is known to be the manifestation of a complex interaction between electrical and structural abnormalities and therefore, true electro-anatomical-structural imaging may elucidate important key factors of AF development, progression, and treatment. Therefore, it is paramount to identify which clinical questions could be successfully addressed by ECGI when it comes to AF characterization and treatment, and which questions may be beyond its technical limitations. In this manuscript we review the questions that researchers have tried to address on the use of ECGI for AF characterization and treatment guidance (for example, localization of AF triggers and sustaining mechanisms), and we discuss the technological requirements and validation. We address experimental and clinical results, limitations, and future challenges for fruitful application of ECGI for AF understanding and management. We pay attention to existing techniques and clinical application, to computer models and (animal or human) experiments, to challenges of methodological and clinical validation. The overall objective of the study is to provide a consensus on valuable directions that ECGI research may take to provide future improvements in AF characterization and treatment guidance.
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影响因子：
4.6
作者：
Cheng, LK;Bodley, JM;Pullan, AJ
通讯作者：
Pullan, AJ
DOI：
10.1016/j.ijcha.2020.100640
发表时间：
2020-10
期刊：
International journal of cardiology. Heart & vasculature
影响因子：
--
作者：
Osorio-Jaramillo E;Klenk S;Angleitner P;Laufer G;Ehrlich MP;Rudziński PN;Ad N
通讯作者：
Ad N
影响因子：
4
作者：
Boyle PM;Hakim JB;Zahid S;Franceschi WH;Murphy MJ;Vigmond EJ;Dubois R;Haïssaguerre M;Hocini M;Jaïs P;Trayanova NA;Cochet H
通讯作者：
Cochet H
影响因子：
3.9
作者：
Tang WH;Ho WH;Chen YJ
通讯作者：
Chen YJ
影响因子：
8.4
作者：
Bear, Laura R.;Cheng, Leo K.;Smaill, Bruce H.
通讯作者：
Smaill, Bruce H.