High-Resolution Electrocardiographic Localization

定位心律失常的来源目前需要一种侵入性的复杂程序。心律失常起源部位的非侵入性定位将对许多患者具有巨大的价值，并将使心脏科医生能够将干预重点放在心律失常的根源上，而不需要冗长的心内标测。目前，与程序化刺激技术相结合的侵入性标测程序与新的治疗技术(包括植入自动心脏除颤器和选择性射频消融心肌组织)一起使用的情况一直在稳步增加。在三维(3D)心肌中定位激活起始点的非侵入性手段的可用性将极大地提高监测和指导侵入性治疗和诊断技术(如程序刺激和选择性导管尖端消融术)的能力。本项目的目标是开发和评估一种新的心电定位方法，用于从无创心电测量中准确、快速地定位心脏激活的起始点。为了实现这一目标，将致力于以下目标：(1)开发和评估一种新的基于心脏模型的方法，借助各向异性的逼真形状的心脏模型，从无创的体表心电测量中快速准确地定位心脏激活的起始点。(2)在一系列良好控制的计算机模拟中，系统地评估所提出的三维心电定位方法的能力。(3)在临床环境下对所提出的三维心电定位方法进行验证。这些目标的工作假设是，通过结合生理过程的先验信息，一个人在解决反问题时将能够获得更大的稳定性和准确性，从而能够准确地定位心脏激活的起始点。

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.