XML-BSPM: an XML format for storing Body Surface Potential Map recordings

<p>Abstract</p> <p>Background</p> <p>The Body Surface Potential Map (BSPM) is an electrocardiographic method, for recording and displaying the electrical activity of the heart, from a spatial perspective. The BSPM has been deemed more accurate for assessing certain cardiac pathologies when compared to the 12-lead ECG. Nevertheless, the 12-lead ECG remains the most popular ECG acquisition method for non-invasively assessing the electrical activity of the heart. Although data from the 12-lead ECG can be stored and shared using open formats such as SCP-ECG, no open formats currently exist for storing and sharing the BSPM. As a result, an innovative format for storing BSPM datasets has been developed within this study.</p> <p>Methods</p> <p>The XML vocabulary was chosen for implementation, as opposed to binary for the purpose of human readability. There are currently no standards to dictate the number of electrodes and electrode positions for recording a BSPM. In fact, there are at least 11 different BSPM electrode configurations in use today. Therefore, in order to support these BSPM variants, the XML-BSPM format was made versatile. Hence, the format supports the storage of custom torso diagrams using SVG graphics. This diagram can then be used in a 2D coordinate system for retaining electrode positions.</p> <p>Results</p> <p>This XML-BSPM format has been successfully used to store the Kornreich-117 BSPM dataset and the Lux-192 BSPM dataset. The resulting file sizes were in the region of 277 kilobytes for each BSPM recording and can be deemed suitable for example, for use with any telemonitoring application. Moreover, there is potential for file sizes to be further reduced using basic compression algorithms, i.e. the deflate algorithm. Finally, these BSPM files have been parsed and visualised within a convenient time period using a web based BSPM viewer.</p> <p>Conclusions</p> <p>This format, if widely adopted could promote BSPM interoperability, knowledge sharing and data mining. This work could also be used to provide conceptual solutions and inspire existing formats such as DICOM, SCP-ECG and aECG to support the storage of BSPMs. In summary, this research provides initial ground work for creating a complete BSPM management system.</p

Noninvasive Assessment of Spatio-Temporal Recurrence in Atrial Fibrillation

Propagation of Atrial Activity during atrial fibrillation (AF) is a complex phenomenon characterized by a certain degree of recurrence (periodic repetition). In this study, we investigated the possibility to detect recurrence noninvasively from body surface potential map recordings in patients affected by persistent AF, and localize this recurrence both in time and space. Results showed that clusters of recurrence can be identified from body surface recordings in these patients. Moreover, the number of clusters detected and their location on the top-right of the back of the torso were significantly associated with AF recurrence 4 to 6 weeks after electrical cardioversion. This suggests that noninvasive quantification of recurrence in persistent AF patients is possible, and may contribute to improve patient stratification

Role of myocardial properties and pacing lead location on ECG in personalized paced heart models

Personalised cardiac models were built from the computed tomography imaging data for two patients with implanted cardiac resynchronisation therapy devices. The cardiac models comprised a biventricular model of myocardial electrophysiology coupled with a model of the torso to simulate the body surface potential map. The models were verified against electrocardiogams (ECG) recorded in the patients from 240 leads on the body surface under left ventricular pacing. The simulated ECG demonstrated a significant sensitivity to the myocardial anisotropy and location of the pacing electrode tip in the models. An apicobasal cellular heterogeneity was shown to be less significant for the ECG pattern at the paced-ventricle activation than that showed earlier by Keller and co-authors (2012) for the normal activation sequence. © 2017 IEEE Computer Society. All rights reserved.This study was supported by the RAS Presidium Programme I.33Π, and Government of the Russian Federation (agreement 02.A03.21.0006). We used the computational clusters of Ural Federal University and ”URAN” of Institute of Mathematics and Mechanics (Ekaterinburg)

A Web-based Visualization Tool for Transforming the 12-lead ECG into a Body Surface Potential Map

Abstract The standard 12-lea

Analysis of spatial variability for the development of reduced lead body surface maps

The spatial frequency of measurement points from standard ECG systems lacks accuracy to diagnose local variability in cardiac activity on the torso. Body Surface Mapping (BSM) improves this accuracy, but lacks the simplicity to be implemented in clinic on a regular basis. Reduced-lead BSM system improves applicability, but currently no standardization of lead reduction has been agreed upon. This research investigates the reduction of BSMs based on Lomb-Scargle Spectral Analysis to determine an appropriate electrode positioning through spatial frequency assessment. Based on the measurement of 13 healthy volunteers, a 128 electrode system could be reduced to a 36 electrode system and an 84 electrode system for ventricular and atrial activity measurements, respectively, with up to 10% loss of the full information provided by the original body surface potential map. Further research will investigate the appropriate positions of these electrodes and the effect of lead reduction for various cardiac abnormalities

Comparing Non-invasive Inverse Electrocardiography With Invasive Endocardial and Epicardial Electroanatomical Mapping During Sinus Rhythm

This study presents a novel non-invasive equivalent dipole layer (EDL) based inverse electrocardiography (iECG) technique which estimates both endocardial and epicardial ventricular activation sequences. We aimed to quantitatively compare our iECG approach with invasive electro-anatomical mapping (EAM) during sinus rhythm with the objective of enabling functional substrate imaging and sudden cardiac death risk stratification in patients with cardiomyopathy. Thirteen patients (77% males, 48 ± 20 years old) referred for endocardial and epicardial EAM underwent 67-electrode body surface potential mapping and CT imaging. The EDL-based iECG approach was improved by mimicking the effects of the His-Purkinje system on ventricular activation. EAM local activation timing (LAT) maps were compared with iECG-LAT maps using absolute differences and Pearson’s correlation coefficient, reported as mean ± standard deviation [95% confidence interval]. The correlation coefficient between iECG-LAT maps and EAM was 0.54 ± 0.19 [0.49–0.59] for epicardial activation, 0.50 ± 0.27 [0.41–0.58] for right ventricular endocardial activation and 0.44 ± 0.29 [0.32–0.56] for left ventricular endocardial activation. The absolute difference in timing between iECG maps and EAM was 17.4 ± 7.2 ms for epicardial maps, 19.5 ± 7.7 ms for right ventricular endocardial maps, 27.9 ± 8.7 ms for left ventricular endocardial maps. The absolute distance between right ventricular endocardial breakthrough sites was 30 ± 16 mm and 31 ± 17 mm for the left ventricle. The absolute distance for latest epicardial activation was median 12.8 [IQR: 2.9–29.3] mm. This first in-human quantitative comparison of iECG and invasive LAT-maps on both the endocardial and epicardial surface during sinus rhythm showed improved agreement, although with considerable absolute difference and moderate correlation coefficient. Non-invasive iECG requires further refinements to facilitate clinical implementation and risk stratification