ABSTRACT
Electrocardiographic Imaging (ECGI) aims to reconstruct electrograms from the body surface potential measurements. Bad leads are usually excluded from the inverse problem solution. Alternatively, interpolation can be applied. This study explores how sensitive ECGI is to different bad-lead configurations and interpolation methods. Experimental data from a Langendorff-perfused pig heart suspended in a human-shaped torso-tank was used. Epicardial electrograms were acquired during 30 s (31 beats) of RV pacing using a 108-electrode array, simultaneously with torso potentials from 128 electrodes embedded in the tank surface. Six different bad lead cases were designed based on clinical experience. Inverse problem was solved by applying Tikhonov regularization i) using the complete data, ii) bad-leads-removed data, and iii) interpolated data, with 5 different methods. Our results showed that ECGI accuracy of an interpolation method highly depends on the location of the bad leads. If they are in the high-potential-gradient regions of the torso, a highly accurate interpolation method is needed to achieve an ECGI accuracy close to using complete data. If the BSP reconstruction of the interpolation method is poor in these regions, the reconstructed electrograms also have lower accuracy, suggesting that bad leads should be removed instead of interpolated. The inverse-forward method was found to be the best among all interpolation methods applied in this study in terms of both missing BSP lead reconstruction and ECGI accuracy, even for the bad leads located over the chest.
ABSTRACT
To overcome the ill-posed nature of the inverse problem of electrocardiography (ECG) and stabilize the solutions, regularization is used. Despite several studies on noise, effect of prefiltering of ECG signals on the regularized inverse solutions has not been explored. We used Bayesian estimation for solving the inverse ECG problem with and without applying various prefiltering methods, and evaluated our results using experimental data that came from a Langendorff-perfused pig heart suspended in a human-shaped torso-tank. Epicardial electrograms were recorded during RV pacing using a 108-electrode array, simultaneously with ECGs from 128 electrodes embedded in the tank surface. Leave-one-beat-out protocol was used to obtain the prior probability density function (pdf) of electro-grams and noise statistics. Noise pdf was assumed to be zero mean-Gaussian, with covariance assumptions: a) independent and identically distributed (noi-iid), b) correlated (noi-corr). Reconstructed electrograms and activation times were compared to those directly recorded by the sock for 3 beats selected from the recording. Noi-corr is superior to noi-iid when the training set is a good match to data, but for applications requiring activation time derivation, careful selection of preprocessing methods, in particular to adequately remove high-frequency noise, and an appropriate noise model is needed.