High-Resolution Electrocardiographic Localization

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0201939HeLocating the source of cardiac arrhythmia currently requires an invasive and complex procedure. Noninvasive localization of sites of origin of arrhythmia would be of enormous value for numerous patients and would allow cardiologists to focus the intervention at the source of the arrhythmia without the need for lengthy intra-cardiac mapping. Currently, invasive mapping procedures in conjunction with programmed stimulation techniques have been steadily increasing in use in combination with newer therapeutic techniques including implantation of automatic intra-cardiac defibrillators and selective radio-frequency ablation of myocardial tissue. The availability of a noninvasive means of localizing sites of origin of activation in three-dimensional (3D) myocardium will greatly increase the ability to help monitor and guide invasive therapeutic and diagnostic techniques such as programmed stimulation and selective catheter-tip ablation. The goal of this project is to develop and evaluate a novel electrocardiographic localization methodology for accurate and rapid localization of sites of origin of cardiac activation from noninvasive electrocardiogram (ECG) measurements. To accomplish this goal the following aims will be addressed: (1) To develop and evaluate a novel heart-model-based approach to rapidly and accurately localize sites of origin of cardiac activation from noninvasive body surface ECG measurements, with the aid of an anisotropic realistically shaped heart model. (2) To systematically evaluate the capability of the proposed 3D electrocardiographic localization approach in a series of well-controlled computer simulations. (3) To validate the proposed 3D electrocardiographic localization approach in a clinical setting. The working hypothesis for these aims is that, by incorporating a priori information on physiological processes, one will be able to achieve greater stability and accuracy when solving the inverse problem, allowing accurately localizing sites of origin of cardiac activation.