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Epicardial Mapping from Intracoronary Catheters. Rob MacLeod, Richard Kuenzler, Quan Ni, Bruno Taccardi, and Bob Lux. NEH Cardiovascular Research and Training Institute (CVRTI), U of Utah. Cardiac Mapping. Coverage Surface or volume Sampling Density. Epicardial Endocardial Venous. - PowerPoint PPT Presentation
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CVRTICVRTICVRTICVRTI
Epicardial Mapping from Intracoronary Catheters
Epicardial Mapping from Intracoronary Catheters
Rob MacLeod,
Richard Kuenzler, Quan Ni, Bruno Taccardi, and Bob Lux
NEH Cardiovascular Research and Training Institute (CVRTI), U of Utah
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Cardiac MappingCardiac Mapping
• Coverage • Surface or volume• Sampling Density
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Catheter MappingCatheter Mapping• Epicardial• Endocardial• Venous
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The QuestionsThe Questions
• What are catheter electrograms?
• Can they provide mapping data?
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Catheter MeasurementsCatheter MeasurementsCROSS SECTIONAL VIEW
CS
Superior Vena Cava
Inferior Vena Cava
• Acute dog preparation
• Cardima 4-16 pole catheters
• High resolution epicardial plaque
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Electrogram ComparisonElectrogram Comparison
Catheter
Epi 1
Epi 2
-10
-20
-30
-40
V [mV]
10
20
0
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Statistical ComparisonStatistical Comparison
Stat. Value
CC
RMSE (mv)
# of Electrograms
Compared
4 mm Plaque
0.955 ± 0.0770.949 ± 0.070
1.316 ± 0.7472.485 ± 1.360
484
2 mm Plaque
0.964 ± 0.0540.960 ± 0.046
1.422 ± 0.4312.801 ± 0.981
176
Signal Type
Whole SignalQRS
Whole SignalQRS
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InterpolationInterpolation
Original
Hardy’s Laplacian
42 electrodes
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InterpolationInterpolation
Original
Hardy’s Laplacian
42 electrodes
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EstimationMatrix
Statistical EstimationStatistical Estimation
CovarianceMatrix
Training Data
*
Sub-sampled Data
=Estimate
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Interpolation vs. EstimationInterpolation vs. Estimation
Original
Hardy’s Laplacian
StatisticalEstimation
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Interpolation vs. EstimationInterpolation vs. Estimation
Original
Hardy’s Laplacian
StatisticalEstimation
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Electrode SpacingElectrode Spacing
Original Estimated: 41 leads(4 mm spacing)
Estimated: 21 leads(8 mm spacing)
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Test GeometryTest Geometry
Coronary Circulation
Surrogate CathetersG
CV
GCV CS
MCVLVP
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Resubstitution Protocol Resubstitution Protocol
Training Data
Experiment 1
Experiment 2
Experiment 3
Experiment 4
Test Data
• Indicator of database quality
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Leave-One-Map-Out Protocol Leave-One-Map-Out Protocol
Training Data
Experiment 1
Experiment 2
Experiment 3
Experiment 4
Test Data
• Intermittent bad lead case
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Leave-One-Experiment-Out Protocol
Leave-One-Experiment-Out Protocol
Training Data
Experiment 1
Experiment 2Experiment 4
Test Data
Experiment 3
• Clinically relevant case
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Original Resubstitution
Leave Out One Map
Leave Out One Experiment
LV PacingLV Pacing
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Anterior Pacing
Anterior Pacing
Original Resubstitution
Leave Out One Map
Leave Out One Experiment
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Apical PacingApical Pacing
Original Resubstitution
Leave Out One Map
Leave Out One Experiment
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Posterior Pacing
Posterior Pacing
Original Resubstitution
Leave Out One Map
Leave Out One Experiment
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Effect of # of Leads
Effect of # of Leads
L-experiment
L-map
Resubstitution
5 10 15 20 25 30 35 40# Catheter Leads
Relative ErrorRelative ErrorMean
Std. Dev.
• leads evenly spaced
• N=153 maps
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Current ResearchCurrent Research
• Acquire larger database– Variety of activation sequences– Range of interventions
• Evaluate other estimation approaches
• Evaluate other basis functions
• Merge estimation with interpolation
