A reference dataset for verifying numerical electrophysiological heart models

<p>Abstract</p> <p>Background</p> <p>The evaluation, verification and comparison of different numerical heart models are difficult without a commonly available database that could be utilized as a reference. Our aim was to compile an exemplary dataset.</p> <p>Methods</p> <p>The following methods were employed: Magnetic Resonance Imaging (MRI) of heart and torso, Body Surface Potential Maps (BSPM) and MagnetoCardioGraphy (MCG) maps. The latter were recorded simultaneously from the same individuals a few hours after the MRI sessions.</p> <p>Results</p> <p>A training dataset is made publicly available; datasets for blind testing will remain undisclosed.</p> <p>Conclusions</p> <p>While the MRI data may provide a common input that can be applied to different numerical heart models, the verification and comparison of different models can be performed by comparing the measured biosignals with forward calculated signals from the models.</p

Wearable Sensors for Monitoring the Physiological and Biochemical Profile of the Athlete

Athletes are continually seeking new technologies and therapies to gain a competitive edge to maximize their health and performance. Athletes have gravitated toward the use of wearable sensors to monitor their training and recovery. Wearable technologies currently utilized by sports teams monitor both the internal and external workload of athletes. However, there remains an unmet medical need by the sports community to gain further insight into the internal workload of the athlete to tailor recovery protocols to each athlete. The ability to monitor biomarkers from saliva or sweat in a noninvasive and continuous manner remain the next technological gap for sports medical personnel to tailor hydration and recovery protocols per the athlete. The emergence of flexible and stretchable electronics coupled with the ability to quantify biochemical analytes and physiological parameters have enabled the detection of key markers indicative of performance and stress, as reviewed in this paper

Bayesian Active Learning for Personalization and Uncertainty Quantification in Cardiac Electrophysiological Model

Cardiacvascular disease is the top death causing disease worldwide. In recent years, high-fidelity personalized models of the heart have shown an increasing capability to supplement clinical cardiology for improved patient-specific diagnosis, prediction, and treatment planning. In addition, they have shown promise to improve scientific understanding of a variety of disease mechanisms. However, model personalization by estimating the patient-specific tissue properties that are in the form of parameters of a physiological model is challenging. This is because tissue properties, in general, cannot be directly measured and they need to be estimated from measurements that are indirectly related to them through a physiological model. Moreover, these unknown tissue properties are heterogeneous and spatially varying throughout the heart volume presenting a difficulty of high-dimensional (HD) estimation from indirect and limited measurement data. The challenge in model personalization, therefore, summarizes to solving an ill-posed inverse problem where the unknown parameters are HD and the forward model is complex with a non-linear and computationally expensive physiological model. In this dissertation, we address the above challenge with following contributions. First, to address the concern of a complex forward model, we propose the surrogate modeling of the complex target function containing the forward model – an objective function in deterministic estimation or a posterior probability density function in probabilistic estimation – by actively selecting a set of training samples and a Bayesian update of the prior over the target function. The efficient and accurate surrogate of the expensive target function obtained in this manner is then utilized to accelerate either deterministic or probabilistic parameter estimation. Next, within the framework of Bayesian active learning we enable active surrogate learning over a HD parameter space with two novel approaches: 1) a multi-scale optimization that can adaptively allocate higher resolution to heterogeneous tissue regions and lower resolution to homogeneous tissue regions; and 2) a generative model from low-dimensional (LD) latent code to HD tissue properties. Both of these approaches are independently developed and tested within a parameter optimization framework. Furthermore, we devise a novel method that utilizes the surrogate pdf learned on an estimated LD parameter space to improve the proposal distribution of Metropolis Hastings for an accelerated sampling of the exact posterior pdf. We evaluate the presented methods on estimating local tissue excitability of a cardiac electrophysiological model in both synthetic data experiments and real data experiments. Results demonstrate that the presented methods are able to improve the accuracy and efficiency in patient-specific model parameter estimation in comparison to the existing approaches used for model personalization

Doctor of Philosophy

dissertationComputational simulation has become an indispensable tool in the study of both basic mechanisms and pathophysiology of all forms of cardiac electrical activity. Because the heart is comprised of approximately 4 billion electrically active cells, it is not possible to geometrically model or computationally simulate each individual cell. As a result computational models of the heart are, of necessity, abstractions that approximate electrical behavior at the cell, tissue, and whole body level. The goal of this PhD dissertation was to evaluate several aspects of these abstractions by exploring a set of modeling approaches in the field of cardiac electrophysiology and to develop means to evaluate both the amplitude of these errors from a purely technical perspective as well as the impacts of those errors in terms of physiological parameters. The first project used subject specific models and experiments with acute myocardial ischemia to show that one common simplification used to model myocardial ischemia-the simplest form of the border zone between healthy and ischemic tissue-was not supported by the experimental results. We propose a alternative approximation of the border zone that better simulates the experimental results. The second study examined the impact of simplifications in geometric models on simulations of cardiac electrophysiology. Such models consist of a connected mesh of polygonal elements and must often capture complex external and internal boundaries. A conforming mesh contains elements that follow closely the shapes of boundaries; nonconforming meshes fit the boundaries only approximately and are easier to construct but their impact on simulation accuracy has, to our knowledge, remained unknown. We evaluated the impact of this simplification on a set of three different forms of bioelectric field simulations. The third project evaluated the impact of an additional geometric modeling error; positional uncertainty of the heart in simulations of the ECG. We applied a relatively novel and highly efficient statistical approach, the generalized Polynomial Chaos-Stochastic Collocation method (gPC-SC), to a boundary element formulation of the electrocardiographic forward problem to carry out the necessary comprehensive sensitivity analysis. We found variations large enough to mask or to mimic signs of ischemia in the ECG

DEVELOPMENT OF PIEZOELECTRIC SENSORS AND METHODOLOGY FOR NONINVASIVE SIMULTANEOUS DETECTION OF MULTIPLE VITAL SIGNS

The activity of piezoelectric material linked the applied electric field with the strain generated that can be translated into geometrical variations. Flexible steel substrate exhibits fascinating mechanical properties which enable their integration into the emerging field of flexible microelectronics. This work presents an extended technique based on capacitance-voltage dependency to extract the geometrical variations in thin-film piezoelectric materials deposited on a flexible steel. A 50 μm flexible steel sheet has been sandwiched by two PZT film layers, each of 2.4 μm in thickness deposited by sputtering. An aluminum layer of 370 nm has been deposited above each PZT layer to form the electrical contact. The steel sheet represents the common electrode for both PZT structures. Gamry references 3000 analyzers were used to collect the capacitance-voltage measurements then estimating the piezoelectric charge constant. Experimental work has been validated by implementing the same method on a bulk piezoelectric film. Results have shown that the measured capacitance varies by 1% due to dielectric constant voltage dependency. On the other hand, 99% of capacitance variations depend on the change in physical dimensions of the sample via the piezoelectric effect. Further to that, this thesis explores the utilization of piezoelectric-based sensors to collect a corresponding representative signal from the chest surface. The subject typically needs to hold his or her breath to eliminate the respiration effect. This work further contributes to the extraction of the corresponding representative vital signs directly from the measured respiration signal. The contraction and expansion of the heart muscles, as well as the respiration activities, will induce a mechanical vibration across the chest wall. This vibration can be converted into an electrical output voltage via piezoelectric sensors. During breathing, the measured voltage signal is composed of the cardiac cycle activities modulated along with the respiratory cycle activity. The proposed technique employs the principles of piezoelectric and signal-processing methods to extract the corresponding signal of cardiac cycle activities from a breathing signal measured in real-time. All the results were validated step by step by a conventional apparatus, with good agreement observed

Electrical Impedance Based Spectroscopy and Tomography Techniques for Obesity and Heart Diseases

Despite advances in diagnosis and therapy, atherosclerosis cardiovascular disease remains the leading cause of morbidity and mortality. Predicting metabolically active atherosclerotic lesions has remained an unmet clinical need. Specially, atherosclerotic plaques that are prone to rupture are of extremely high-risk and can cause detrimental heart attacks and/or strokes, leading to sudden death. It has been shown that atheroscleroses is correlated to the level of obesity of an individual [1] Usually in clinical practice, the doctor will assess a patient's "risk factor" based on his or her Body Mass Index (BMS), and measurement of the waist circumference. Meanwhile the level of fatty droplet deposits in the liver is an important bio-marker to assess the patient's risk factor, however the patient will need to undergo radiation imaging such as CT scan or MRI scan. For the vulnerable plaques that can lead to sudden rupture, the ability to distinguish them at an early stage remains largely lacking. Therefore it is of great clinical interest to find improved diagnostic techniques to identify and localize such vulnerable plaques. Meanwhile, lipid has significantly lower electrical impedance than the rest of the vessel tissues in certain frequency bands [2]. In this thesis we explore spectroscopic and tomographic methods to characterize such plaques. In addition, with the Electrical Impedance Tomography method we will propose a novel method to detect fatty liver in an early stage with non-radiating and non-invasive manner.</p

三次元心臓モデルと不均一振動モデルによる心臓活動電位のコンピュータシミュレーション

Tohoku University西條芳文論

Electrocardiogram Signal Analysis and Simulations for Non-Invasive Diagnosis - Model-Based and Data-Driven Approaches for the Estimation of Ionic Concentrations and Localization of Excitation Origins

Das Elektrokardiogramm (EKG) ist die Standardtechnik zur Messung der elektrischen Aktivität des Herzens. EKG-Geräte sind verfügbar, kostengünstig und erlauben zudem eine nichtinvasive Messung. Das ist insbesondere wichtig für die Diagnose von kardiovaskulären Erkrankungen (KVE). Letztere sind mit verursachten Kosten von 210 Milliarden Euro eine der Hauptbelastungen für das Gesundheitssystem in Europa und dort der Grund für 3,9 Millionen Todesfälle – dies entspricht 45% aller Todesfälle. Neben weiteren Risikofaktoren spielen chronische Nierenerkrankungen und strukturelle Veränderungen des Herzgewebes eine entscheidende Rolle für das Auftreten von KVE. Deshalb werden in dieser Arbeit zwei Pathologien, die in Verbindung zu KVE stehen, betrachtet: Elektrolytkonzentrationsveränderungen bei chronisch Nierenkranken und ektope Foki, die autonom Erregungen iniitieren. In beiden Projekten ist die Entwicklung von Methoden mithilfe von simulierten Signalen zur Diagnoseunterstützung das übergeordnete Ziel. Im ersten Projekt helfen simulierte EKGs die Signalverarbeitungskette zur EKG-basierten Schätzung der Ionenkonzentrationen von Kalium und Calcium zu optimieren. Die Erkenntnisse dieser Optimierung fließen in zwei patienten-spezifische Methoden zur Kaliumkonzentrationsschätzung ein, die wiederum mithilfe von Patientendaten ausgewertet werden. Die Methoden lieferten im Mittel einen absoluten Fehler von 0,37 mmol/l für einen patienten-spezifischen Ansatz und 0,48 mmol/l für einen globalen Ansatz mit zusätzlicher patienten-spezifischer Korrektur. Die Vorteile der Schätzmethoden werden gegenüber bereits existierender Ansätze dargelegt. Alle entwickelten Algorithmen sind ferner unter einer Open-Source-Lizenz veröffentlicht. Das zweite Projekt zielte auf die Lokalisierung von ektopen Foki mithilfe des EKGs ohne die Nutzung der individuellen Patientengeometrie. 1.766.406 simulierte EKG-Signale (Body Surface Potential Maps (BSPMs)) wurden zum Trainieren von zwei Convolutional Neural Networks (CNNs) erzeugt. Das erste CNN sorgt für die Schätzung von Anfang und Ende der Depolarisation der Ventrikel. Das zweite CNN nutzt die Information der Depolarisation im BSPM zur Schätzung des Erregungsurpsrungs. Der spezielle Aufbau des CNNs ermöglicht die Darstellung mehrerer Lösungen, wie sie durch Mehrdeutigkeiten im BSPM vorliegen können. Der kleinste Median des Lokalisierungsfehlers lag bei 1,54 mm für den Test-Datensatz der simulierten Signale, bzw. bei 37 mm für Patientensignale. Somit erlaubt die Kombination beider CNNs die verlässliche Lokalisierung von ektopen Foki auch anhand von Patientendaten, obwohl Patientendaten vorher nicht im Training genutzt wurden. Die Resultate dieser zwei Projekte demonstrieren, wie EKG-Simulationen zur Entwicklung und Verbesserung von EKG-Signalverarbeitungsmethoden eingesetzt werden und bei der Diagnosefindung helfen können. Zudem zeigt sich das Potential der Kombination von Simulationen und CNNs, um einerseits die zumeist raren klinischen Signale zu ersetzen und andererseits Modelle zu finden, die für mehrere Patienten/-innen gültig sind. Die vorgestellten Methoden bergen die Möglichkeit, die Diagnosestellungen zu beschleunigen und mit hoher Wahrscheinlichkeit den Therapieerfolg der Patienten zu verbessern

Computer-Assisted Electroanatomical Guidance for Cardiac Electrophysiology Procedures

Cardiac arrhythmias are serious life-threatening episodes affecting both the aging population and younger patients with pre-existing heart conditions. One of the most effective therapeutic procedures is the minimally-invasive catheter-driven endovascular electrophysiology study, whereby electrical potentials and activation patterns in the affected cardiac chambers are measured and subsequent ablation of arrhythmogenic tissue is performed. Despite emerging technologies such as electroanatomical mapping and remote intraoperative navigation systems for improved catheter manipulation and stability, successful ablation of arrhythmias is still highly-dependent on the operator’s skills and experience. This thesis proposes a framework towards standardisation in the electroanatomical mapping and ablation planning by merging knowledge transfer from previous cases and patient-specific data. In particular, contributions towards four different procedural aspects were made: optimal electroanatomical mapping, arrhythmia path computation, catheter tip stability analysis, and ablation simulation and optimisation. In order to improve the intraoperative electroanatomical map, anatomical areas of high mapping interest were proposed, as learned from previous electrophysiology studies. Subsequently, the arrhythmic wave propagation on the endocardial surface and potential ablation points were computed. The ablation planning is further enhanced, firstly by the analysis of the catheter tip stability and the probability of slippage at sparse locations on the endocardium and, secondly, by the simulation of the ablation result from the computation of convolutional matrices which model mathematically the ablation process. The methods proposed by this thesis were validated on data from patients with complex congenital heart disease, who present unusual cardiac anatomy and consequently atypical arrhythmias. The proposed methods also build a generic framework for computer guidance of electrophysiology, with results showing complementary information that can be easily integrated into the clinical workflow.Open Acces