Sensitivity- and Effort-Gain Analysis: Multilead ECG Electrode Array Selection for Activation Time Imaging

Methods for noninvasive imaging of electric function of the heart might become clinical standard procedure the next years. Thus, the overall procedure has to meet clinical requirements as an easy and fast application. In this paper, we propose a new electrode array which improves the resolution of methods for activation time imaging considering clinical constraints such as easy to apply and compatibility with routine leads. For identifying the body-surface regions where the body surface potential (BSP) is most sensitive to changes in transmembrane potential (TMP), a virtual array method was used to compute local linear dependency (LLD) maps. The virtual array method computes a measure for the LLD in every point on the body surface. The most suitable number and position of the electrodes within the sensitive body surface regions was selected by constructing effort gain (EG) plots. Such a plot depicts the relative attainable rank of the leadfield matrix in relation to the increase in number of electrodes required to build the electrode array. The attainable rank itself was computed by a detector criterion. Such a criterion estimates the maximum number of source space eigenvectors not covered by noise when being mapped to the electrode space by the leadfield matrix and recorded by a detector. From the sensitivity maps, we found that the BSP is most sensitive to changes in TMP on the upper left frontal and dorsal body surface. These sensitive regions are covered best by an electrode array consisting of two L-shaped parts of ~30 cmtimes30 cm and ~20 cmtimes20 cm. The EG analysis revealed that the array meeting clinical requirements best and improving the resolution of activation time imaging consists of 125 electrodes with a regular horizontal and vertical spacing of 2-3 cm

[1]  A. van Oosterom,et al.  Model Studies with the Inversely Calculated lsochrones of Ventricular Depolarization , 1984, IEEE Transactions on Biomedical Engineering.

[2]  Robert Modre,et al.  Model-based imaging of cardiac electrical excitation in humans , 2002, IEEE Transactions on Medical Imaging.

[3]  Robert Modre,et al.  A new spatiotemporal regularization approach for reconstruction of cardiac transmembrane potential patterns , 2004, IEEE Transactions on Biomedical Engineering.

[4]  Y. Rudy,et al.  The Inverse Problem in Electrocardiography: A Model Study of the Effects of Geometry and Conductivity Parameters on the Reconstruction of Epicardial Potentials , 1986, IEEE Transactions on Biomedical Engineering.

[5]  Y. Rudy,et al.  Imaging Dispersion of Myocardial Repolarization, I: Comparison of Body-Surface and Epicardial Measures , 2001, Circulation.

[6]  Robert Modre,et al.  Lead field computation for the electrocardiographic inverse problem - finite elements versus boundary elements , 2005, Comput. Methods Programs Biomed..

[7]  Olaf Dössel,et al.  OPPORTUNITIES AND LIMITATIONS OF NON-INVASIVE BIOELECTRIC IMAGING OF THE HEART , 1999 .

[8]  Olaf Dössel,et al.  THE EFFECT OK CARDIAC ANISOTROPY ON THE RECONSTRUCTION OF TRANSMEMBRANE VOLTAGES IN THE HEART , 2003 .

[9]  Y. Rudy,et al.  A Noninvasive Imaging Modality for Cardiac Arrhythmias , 2000, Circulation.

[10]  S. Usui,et al.  Wigner distribution analysis of BSPM for optimal sampling , 1990, IEEE Engineering in Medicine and Biology Magazine.

[11]  P J Bourdillon,et al.  A Fourier technique for simultaneous electrocardiographic surface mapping. , 1974, Cardiovascular research.

[12]  R L Lux,et al.  Electrocardiographic body surface potential mapping. , 1982, Critical reviews in biomedical engineering.

[13]  J. A. Abildskov,et al.  Limited Lead Selection for Estimation of Body Surface Potential Maps in Electrocardiography , 1978, IEEE Transactions on Biomedical Engineering.

[14]  G. Huiskamp,et al.  A new method for myocardial activation imaging , 1997, IEEE Transactions on Biomedical Engineering.

[15]  Robert Modre,et al.  Noninvasive myocardial activation time imaging: a novel inverse algorithm applied to clinical ECG mapping data , 2002, IEEE Transactions on Biomedical Engineering.

[16]  Bernhard Pfeifer,et al.  Cardiac anisotropy: is it negligible regarding noninvasive activation time imaging? , 2006, IEEE Transactions on Biomedical Engineering.

[17]  R. Barr,et al.  Relating Epicardial to Body Surface Potential Distributions by Means of Transfer Coefficients Based on Geometry Measurements , 1977, IEEE Transactions on Biomedical Engineering.

[18]  Y Rudy,et al.  The inverse problem in electrocardiography: solutions in terms of epicardial potentials. , 1988, Critical reviews in biomedical engineering.

[19]  J. Ross,et al.  Fiber Orientation in the Canine Left Ventricle during Diastole and Systole , 1969, Circulation research.

[20]  A SippensGroenewegen,et al.  Body surface mapping during pacing at multiple sites in the human atrium: P-wave morphology of ectopic right atrial activation. , 1998, Circulation.

[21]  F. Greensite Cardiac Electromagnetic Imaging as an Inverse Problem , 2001 .

[22]  C. Kremser,et al.  Computationally efficient noninvasive cardiac activation time imaging. , 2005, Methods of information in medicine.

[23]  D. Geselowitz,et al.  Source-Field Relationships for Cardiac Generators on the Heart Surface Based on Their Transfer Coefficients , 1985, IEEE Transactions on Biomedical Engineering.

[24]  Y. Rudy,et al.  Noninvasive electrocardiographic imaging for cardiac electrophysiology and arrhythmia , 2004, Nature Medicine.

[25]  Xin Zhang,et al.  Noninvasive imaging of cardiac transmembrane potentials within three-dimensional myocardium by means of a realistic geometry anisotropic heart model , 2003, IEEE Transactions on Biomedical Engineering.

[26]  B. Pfeifer,et al.  Multi-lead ECG electrode array for clinical application of electrocardiographic inverse problem , 2004, The 26th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[27]  O. Dossel,et al.  Optimization of electrode positions for multichannel electrocardiography with respect to electrical imaging of the heart , 1998, Proceedings of the 20th Annual International Conference of the IEEE Engineering in Medicine and Biology Society. Vol.20 Biomedical Engineering Towards the Year 2000 and Beyond (Cat. No.98CH36286).