High-Resolution Measurement of Local Activation Time Differences From Bipolar Electrogram Amplitude.
High-Resolution Measurement of Local Activation Time Differences From Bipolar Electrogram Amplitude.
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DOI：
10.3389/fphys.2021.653645
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发表时间：
2021
影响因子：
4
通讯作者：
Henriquez C
中科院分区：
文献类型：
--
作者：
Gaeta S;Bahnson TD;Henriquez C
心肌传导速度(CV)的局部改变是导致心律失常的，但在临床电生理过程中，尚不可能对局部CV进行高分辨率标测。这在一定程度上是因为在小空间尺度(1 Mm)下测量局部CV需要以非常高的时间分辨率(≤1ms)准确地注释局部激活时间(LAT)差异，而不是标准的临床方法。我们试图开发一种高分辨率测量LAT差异的方法，并对照现有技术进行验证。首先，我们使用一个简化的理论模型来确定一对电极的LAT差异与它们之间测得的双极EGM的峰值幅度之间的定量关系。这允许通过一种新的“通过幅度变换确定EGM潜伏期”(Delta)方法，根据双极EGM峰值幅度来计算LAT差异。接下来，我们使用一个计算模型中的模拟EGM来验证该方法。在1 kHz采样的情况下，Delta比标准LAT注释更准确地测量小于4ms的LAT差异(平均误差3.8%对22.9%)。在一维和二维模型中，使用Delta方法发现的LAT差异计算CV比使用标准LAT注释(通过单极DV/DT计时)更准确。在包含纤维化的模型中模拟的复杂分级EGM中，Delta衍生的LAT差异比标准LAT注释更准确。最后，我们利用10例接受导管消融的房颤患者左心房记录的18,740个双极EGM，在体内验证了Delta方法。使用临床EGM，通过Delta、标准LAT注释和单极波形互相关发现的LAT差异是一致的。这些结果证明了双极EGM的峰值幅度与其两个电极之间的激活时间差之间的潜在关系。我们的计算模型和临床结果表明，这种关系可以在临床上用于提高微小LAT差异的测量精度，这可能会改善小空间尺度上的CV测量。
Localized changes in myocardial conduction velocity (CV) are pro-arrhythmic, but high-resolution mapping of local CV is not yet possible during clinical electrophysiology procedures. This is in part because measurement of local CV at small spatial scales (1 mm) requires accurate annotation of local activation time (LAT) differences with very high temporal resolution (≤1 ms), beyond that of standard clinical methods. We sought to develop a method for high-resolution measurement of LAT differences and validate against existing techniques. First, we use a simplified theoretical model to identify a quantitative relationship between the LAT difference of a pair of electrodes and the peak amplitude of the bipolar EGM measured between them. This allows LAT differences to be calculated from bipolar EGM peak amplitude, by a novel “Determination of EGM Latencies by Transformation of Amplitude” (DELTA) method. Next, we use simulated EGMs from a computational model to validate this method. With 1 kHz sampling, LAT differences less than 4 ms were more accurately measured with DELTA than by standard LAT annotation (mean error 3.8% vs. 22.9%). In a 1-dimensional and a 2-dimension model, CV calculations were more accurate using LAT differences found by the DELTA method than by standard LAT annotation (by unipolar dV/dt timing). DELTA-derived LAT differences were more accurate than standard LAT annotation in simulated complex fractionated EGMs from a model incorporating fibrosis. Finally, we validated the DELTA method in vivo using 18,740 bipolar EGMs recorded from the left atrium of 10 atrial fibrillation patients undergoing catheter ablation. Using clinical EGMs, there was agreement in LAT differences found by DELTA, standard LAT annotation, and unipolar waveform cross-correlation. These results demonstrate an underlying relationship between a bipolar EGM’s peak amplitude and the activation time difference between its two electrodes. Our computational modeling and clinical results suggest this relationship can be leveraged clinically to improve measurement accuracy for small LAT differences, which may improve CV measurement at small spatial scales.
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DOI：
10.1161/circep.116.004107
发表时间：
2016-07
期刊：
Circulation. Arrhythmia and electrophysiology
影响因子：
--
作者：
Massé S;Magtibay K;Jackson N;Asta J;Kusha M;Zhang B;Balachandran R;Radisic M;Deno DC;Nanthakumar K
通讯作者：
Nanthakumar K
影响因子：
5.5
作者：
Gaeta S;Bahnson TD;Henriquez C
通讯作者：
Henriquez C
影响因子：
20.1
作者：
SPACH, MS;SERWER, GA;JOHNSON, EA
通讯作者：
JOHNSON, EA
DOI：
10.1016/j.jacep.2016.12.016
发表时间：
2017-03-01
期刊：
JACC. Clinical electrophysiology
影响因子：
--
作者：
Leshem, Eran;Tschabrunn, Cory M;Anter, Elad
通讯作者：
Anter, Elad
影响因子：
4.3
作者：
Gokhale, Tanmay A.;Asfour, Huda;Henriquez, Craig S.
通讯作者：
Henriquez, Craig S.