Upload
others
View
4
Download
0
Embed Size (px)
Citation preview
Figure 2.1A.
+-+-+-+-+-+-+-+-
Measurement pointReference point at a
far distance
+-+-+-+-+-+-+-+-
Reference point at a
far distance
Measurement points
E1E2
Vbipolar = VE1 –VE2
Depolarization wave front
dipole
Figure 2.1B.
E+E-
Figure 2.2A. 100 ms
V1
II
HBp
HBd
CSd
CSp
I
HBm
21+, 22- 22+, 21-
Figure 2.2B. 100 ms
V1
II
CSp
I
CSd
MAPp
MAPd
UNI-1
UNI-2
21+, 6- 21-, 6+
Tip
Ring
Bipolar
Figure 2.3A.
Tip
Ring
Bipolar
Figure 2.3B.
Tip
Ring
Bipolar
Figure 2.3C.
Tip
Ring
Bipolar
Figure 2.3D.
Tip
Ring
Bipolar
Figure 2.3E.
Tip
Ring
Bipolar
Tip
Ring
Bipolar
Figure 2.3F.
QS
Pattern
QS
Pattern
Figure 2.4A.
Tip
Ring
Bipolar
Figure 2.4B.
+-+-+-+-+-+-+-+-
+-+-+-+-+-+-+-+-
Figure 2.5A.
Tip
Ring
Tip-Ring
Tip
Ring
Tip-Ring+
+
+-+
+
+-
Figure 2.5B.
Tip
Ring
Bipolar
Figure 2.6A.
Tip
Ring
Bipolar
Figure 2.6B.
Tip
Ring
Bipolar
Figure 2.6C.
Tip
Ring
Bipolar
Figure 2.6D.
Tip
Ring
Bipolar
Figure 2.6E.
Tip
Ring
Tip-Ring
Tip
Ring
Tip-Ring
Tip
Ring
Tip-Ring
Tip
Ring
Tip-Ring
Tip
Ring
Tip-Ring
1.
2.
3.
4.
5.
Figure 2.6F.
Figure 2.7A.
tip
ring
bipolar
Figure 2.7B.
Bipole
Pin 75-76
2 mm apart
Bipole
Pin 75-78
9 mm apart
Bipole
Pin 75-80
16 mm apart
=
+
t
+
0.6cos(2π120t)
1.7cos(2π50t)
x(t)
Figure 2.8A.
=
t
++
1cos(2π20t)
2cos(2π13t)
x(t)
=
Figure 2.8B.
+
+
+
=
0.6cos(2π120t)
1.7cos(2π50t)
1cos(2π20t)
2cos(2π13t)
x(t)
+
+
+
=
tFigure 2.8C.
frequency (Hz)
am
pli
tude
0.6cos(2π120t)
1.7cos(2π50t)
1cos(2π20t)
2cos(2π13t) Mathematical description
in time domain
Figure 2.8D.
filters
and
gain
• Analog pre-amplifier
• Highpass and Lowpass filters
• Gain
filters
and
gain
filters
and
gain
Anal
og
-to-D
igit
al
Conver
sion
Digitization
display
storage
Computer
Command
and Control
Stage 1 Stage 2
Intra-cardiac Signals
ECG Signals
Figure 2.9A.
Figure 2.9B.
IIV1
RAA
HBP
HBD
CSP
CSD
I
MAPP
MAPD
UNI-1
UNI-2
Noise
High signal-to-noise ratio (SNR))
Low SNR
Very Low SNR
Figure 2.10A.
Figure 2.10B.
freq
am
pl
freq
am
pl
1 1
low high low high
freq
am
pl
freq
am
pl
1 1
low high low high
Low Pass High Pass
Band Pass Band Reject
high
corner
frequency
low corner
frequency
lower
end
upper
end
frequency (Hz)
am
plit
ude
60 Hz
Figure 2.10C.
Figure 2.10D.
II
60 Hz notch filter off 60 Hz notch filter on
Figure 2.11A.
IIV1
RAA
HBP
HBD
CSP
CSD
1-250 Hz
I
MAPP
MAPD
30-250 Hz1-500 Hz
UNI-1
UNI-2
Unipolar
Filter
1 -500 Hz 0.1 - 500 Hz
IIV1
RAA
HBP
HBD
CSP
CSD
I
MAPP
MAPD
UNI-1
UNI-2
artifact
artifact
Unipolar
Filter
Figure 2.11B.
Figure 2.11C.
IIV1
RAA
HBP
HBD
CSP
CSD
I
MAPP
MAPD
0.1 - 500 Hz
UNI-1
UNI-2
Figure 2.11D.
IIV1
RAA
HBP
HBD
CSP
CSD
I
MAPP
MAPD
1 - 500 Hz
UNI-1
UNI-2
All frequencies below 80 Hz are
multiplied by 1, so they remain
as they are.
Filt
er
resp
on
se
am
plit
ud
e
All frequencies above 80 Hz
are multiplied by 0, so they
are eliminated.
Frequency (Hz)
EG
frequency c
om
positio
n a
mplitu
de
Figure 2.12A.
low corner
frequencyhigh corner
frequency
Am
plitu
de
Bandpass
Figure 2.12B.
60 Hz
59.6 Hz 60.4 Hz
60 Hz
ringing
ringing
ringing
Figure 2.12C.
frequency (Hz)
am
plitu
de
corner frequency
(100 Hz)
Figure 2.12D
Figure 2.13A
Original
electrogram
Filtered
electrogram
“noise” is
gonehigh-frequency peaks
attenuated and slurred
Time
Figure 2.13B
Raw Data
30-250 Hz filter
high frequency:
little change
lower frequency:
inversion of
morphology!
Time Phase delay
Raw Data
10-250 Hz
20-250 Hz
30-250 Hz
40-250 Hz
50-250 Hz
60-250 Hz
Time Figure 2.13C
Figure 2.13D
Noise-free data
Data with
60-Hz Noise
Notch Filter
Adaptive Filter
Time
Figure 2.14A 0.67 – 21 Hz
I
II
III
aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
Figure 2.14B.
I
II
III
aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
Figure 2.14C
ECG filter: 0.05 - 100 HzECG filter: 1 - 100 Hz
Figure 2.14D
Figure 2.15A
Filter: 1-100 Hz
Figure 2.15B
Filter: 0.05-100 Hz
100 ms
RAA
HBP
HB3
HB2
HBd
HBd
Pin 7-8
Notch filter off
HBd
Pin 7-10
Notch filter off
HBd
Pin 7-10
Notch filter on
H/RB H/RB H/RBV
V
V
Figure 2.16A
100 ms
Electrodes:
2 mm apart
Adaptive filter on
Electrodes:
2 mm apart
Notch filter off
Electrodes:
2 mm apart
Notch filter on
Electrodes:
12 mm apart
Adaptive filter on
Electrodes:
12 mm apart
Notch filter off
Electrodes:
12 mm apart
Notch filter on
Figure 2.16B
100 msFigure 2.17A.
RAA
V1
II
HBp
HBd
I
MAPP
MAPd
UNI-1
UNI-2
Figure 2.17B. 100 ms
RAA
V1
II
HBp
HBd
I
MAPP
MAPd
UNI-1
UNI-2
Figure 2.18A
I
V1
RAA
HBP
HBD
CSP
CSD
LVP
LVD
I
V1
RAA
HBP
HBD
CSP
CSD
LVP
LVD
Figure 2.18B
RA LA
LL
Wilson’s Central Terminal
Figure 2.19A.
Figure 2.19B
Figure 2.19C
Noise on ECG ECG generated by Stimulator
Figure 2.19D
60 Hz notch filter off 60 Hz notch filter on
Figure 2.20A
Foot end of
x-ray table
Head end of
x-ray table
CARTO
Patient-Interface
Unit (PIU)
Bard
Pin Box
Boom
ThermoCool
saline pump
Bard amplifier
RF generator
Figure 2.20B.
Figure 2.20C
Figure 2.20D.
All cables stay above floor !
AC power supply
of CARTO-3 PIU
Figure 2.21A
Figure 2.21B
Figure 2.22A
Figure 2.22B
Figure source: Wikipedia
Figure 2.22C
Figure 2.22D
HEAD FOOT
0.2 mG
8 mG
0.9 mG
3 mG
mG = milli Gauss
X-ray system NOT turned on
Figure 2.23A.
HEAD FOOT
>100 mG
8 mG
6.9 mG
18 mG
mG = milli Gauss
X-ray system turned on
Figure 2.23B.
Tri-field meter
60 mG
0 mG
Zoll defibrillator 6-8 mGaussiv bump: 5-6 mGaussFigure 2.24A.
Flush tubing
Ceiling hanger
Figure 2.24B.
Figure 2.25A
MAPp
MAPd
60 Hz Filter Off 60 Hz Filter On
Figure 2.25B
MAPp
MAPd
60 Hz Filter Off Adaptive Filter On
Figure 2.25C
UNI-1
MAPd
0.17 mV
0.03 mV
Figure 2.25D
UNI-1
MAPd
0.09 mV 0.05 mV
RA LA
LL
Lead-I
Figure 2.26A.
RA LA
LL
Wilson’s Central Terminal
Figure 2.26B.
Figure 2.26C.
Figure 2.26D.
Figure 2.27A.
Figure 2.27B.
RAA
V1
II
HBp
HBd
CSd
CSp
I
MAPP
MAPd
UNI-1
UNI-2
Figure 2.27C.
Figure 2.27D.
RAAV1
II
HBp
HBd
CSd
CSp
I
MAPP
MAPd
UNI-1
UNI-2
Figure 2.28A.
RAAV1
II
HBp
HBd
CSd
CSp
I
MAPP
MAPd
UNI-1
UNI-2
Power Impedance Temperature
Figure 2.28B.
RAA
V1
II
HBp
HBd
I
MAPP
MAPd
CS p
CS 9
CS 8
CS d
Figure 2.29A.
RAA
V1
II
HBp
HBd
I
MAPP
MAPd
CS p
CS 9
CS 8
CS d
Figure 2.29B.
Figure 2.30A.
RAA
V1
II
HBp
HB3
I
HB2
HBd
BARD CARTO® 3
HBp: pin 13+ 14-
(7, 8)
(9,10
(11,12
Figure 2.30B.
HBp: pin 12, 14 HBp: pin 12, 13
RAA
V1
II
HBp
HB3
I
HB2
HBd
(7, 8)
(9,10)
(11,12)
RAA
V1
II
HBp
HBd
I
MAPP
MAPd
UNI-1
UNI-2
100 msFigure 2.31A.
100 ms
RAA
V1
II
HBp
HBd
I
MAPP
MAPd
UNI-1
UNI-2
Figure 2.31B.
100 ms
RAAV1
HBp
HBd
CSd
CSp
I
MAPP
MAPd
UNI-1
UNI-2
MAPd: Pin 1, 2 MAPp: Pin 3, 4
Figure 2.32A.
100 ms
RAAV1
HBp
HBd
CSd
CSp
I
MAPP
MAPd
UNI-1
UNI-2
MAPd: Pin 1, 3 MAPp: Pin 2, 4
Figure 2.32B.
200 ms
RV
RAAV1
II
HBp
HBd
CSd
CSp
I
MAPP
MAPd
UNI-1
UNI-2
Figure 2.33