Ultrasound ceramic transducer arrays : control, transmission and reception circuits

Orientador: Eduardo Tavares CostaDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia Eletrica e de ComputaçãoResumo: Os equipamentos de imagem por ultra-som associam diferentes técnicas e provêm informações não só das estruturas anatômicas como também do estado funcional dos diversos sistemas, em tempo real, com excelente qualidade de imagem. Isto se deve ao desenvolvimento de transdutores cada vez mais aprimorados e, ainda, da utilização de eletrônica digital, analógica e mista com microprocessadores, processadores digitais de sinais (DSPs - digital signal processors) e lógica programável (FPGAs - field programmable gate arrays) cada vez mais rápidos e potentes, aliados à utilização de novas técnicas de processamento digital de sinais e de imagens. O presente trabalho teve como objetivo o desenvolvimento de circuitos de acionamento de elementos cerâmicos de transdutores matriciais. Estes circuitos são responsáveis pela geração e recepção de ondas ultra-sônicas e foram desenvolvidos utilizando técnicas de projetos específicos de placas de circuito impresso de alta freqüência e multicamadas. Foram utilizados componentes SMD (surface-mounted devices) para redução do tamanho do hardware. O sistema é formado por um circuito de controle, uma placa de interligação, uma fonte de alimentação com 10 níveis de tensão, e duas placas de circuito impresso (PCI) contendo os circuitos de transmissão e de recepção (4 canais) para transdutores de ultra-som matriciais. No circuito de controle foi utilizada a linguagem de descrição de hardware VHDL. Este circuito de controle é capaz de executar a variação de largura de pulso, taxa de repetição e defasagem de acionamento dos elementos do transdutor matricial para focalização e deflexão do feixe acústico. Os circuitos de transmissão geram pulsos de até +65V e são disparados pelos pulsos digitais do circuito de controle (mínimo de 20ns de largura). Os circuitos de proteção são eficientes atenuando os pulsos de alta tensão na entrada do circuito de recepção e permitindo a passagem dos ecos. Os circuitos de recepção são formados por circuitos integrados de tecnologia mista (analógico e digital) com faixa de passagem de 100 MHz, baixo ruído e ganho máximo de 70dB. Este ganho pode ser configurado através dos três estágios de amplificação independentes do componente utilizado (LNA, VCA e PGA). O sistema foi testado em laboratório e apresentou desempenho adequado, mostrando-se versátil, permitindo seu uso com transdutores matriciais e mostrando-se interessante ferramenta para laboratórios de ensino e pesquisa em ultra-som.Abstract: Ultrasound image equipments associate different techniques to provide not only anatomical but also functional information of body parts and organs in real time and with excellent image quality. This is due to great advances in transducer technology and also to digital and analog electronics with the use of microcomputers, digital signal processors (DSPs) and field programmable gate arrays (FPGAs) even faster and powerful, allied to new digital signal and image processing techniques. The objective of the present work was the development and construction of circuits to actuate on piezoelectric ceramic transducer arrays. The circuits are able to generate and receive ultrasound waves and were developed with techniques for high frequency multilayer printed circuit boards. In order to reduce hardware size it was used surface mounted devices (SMD). The system consists of a control circuit, a interconnection board, power supply (10 different voltage), two four channel printed circuit boards with the transmission and reception circuits to be used with transducer arrays. It was used VHDL for hardware description language and the control circuit defines pulse width, repetition rate and temporal phasing for activation of each element of the transducer array enabling focusing and ultrasound beam in different directions. The transmission circuits generate pulses up to +65V that are triggered by the control circuit (20 ns minimum pulse width). The protection circuit is very efficient avoiding high tension electrical surges. The reception circuits have mixed technologies (analog and digital integrated circuits) with 100 MHz bandwidth , low noise and up to 70 dB gain. This gain can be programmed through 3 independent amplification stages (LNA, VCA and PGA). The system has been tested in laboratory and presented adequate performance, being versatile and allowing its use with array transducers becoming an interesting tool for education and research purposes.MestradoEngenharia BiomedicaMestre em Engenharia Elétric

Circle Method for Robust Estimation of Local Conduction Velocity High-Density Maps From Optical Mapping Data: Characterization of Radiofrequency Ablation Sites

Conduction velocity (CV) slowing is associated with atrial fibrillation (AF) and reentrant ventricular tachycardia (VT). Clinical electroanatomical mapping systems used to localize AF or VT sources as ablation targets remain limited by the number of measuring electrodes and signal processing methods to generate high-density local activation time (LAT) and CV maps of heterogeneous atrial or trabeculated ventricular endocardium. The morphology and amplitude of bipolar electrograms depend on the direction of propagating electrical wavefront, making identification of low-amplitude signal sources commonly associated with fibrotic area difficulty. In comparison, unipolar electrograms are not sensitive to wavefront direction, but measurements are susceptible to distal activity. This study proposes a method for local CV calculation from optical mapping measurements, termed the circle method (CM). The local CV is obtained as a weighted sum of CV values calculated along different chords spanning a circle of predefined radius centered at a CV measurement location. As a distinct maximum in LAT differences is along the chord normal to the propagating wavefront, the method is adaptive to the propagating wavefront direction changes, suitable for electrical conductivity characterization of heterogeneous myocardium. In numerical simulations, CM was validated characterizing modeled ablated areas as zones of distinct CV slowing. Experimentally, CM was used to characterize lesions created by radiofrequency ablation (RFA) on isolated hearts of rats, guinea pig, and explanted human hearts. To infer the depth of RFA-created lesions, excitation light bands of different penetration depths were used, and a beat-to-beat CV difference analysis was performed to identify CV alternans. Despite being limited to laboratory research, studies based on CM with optical mapping may lead to new translational insights into better-guided ablation therapies

An interactive platform to guide catheter ablation in human persistent atrial fibrillation using dominant frequency, organization and phase mapping

Background and Objective: Optimal targets for persistent atrial fibrillation (persAF) ablation are still debated. Atrial regions hosting high dominant frequency (HDF) are believed to participate in the initiation and maintenance of persAF and hence are potential targets for ablation, while rotor ablation has shown promising initial results. Currently, no commercially available system offers the capability to automatically identify both these phenomena. This paper describes an integrated 3D software platform combining the mapping of both frequency spectrum and phase from atrial electrograms (AEGs) to help guide persAF ablation in clinical cardiac electrophysiological studies. Methods: 30 s of 2048 non-contact AEGs (EnSite Array, St. Jude Medical) were collected and analyzed per patient. After QRST removal, the AEGs were divided into 4 s windows with a 50% overlap. Fast Fourier transform was used for DF identification. HDF areas were identified as the maximum DF to 0.25 Hz below that, and their centers of gravity (CGs) were used to track their spatiotemporal movement. Spectral organization measurements were estimated. Hilbert transform was used to calculate instantaneous phase. Results: The system was successfully used to guide catheter ablation for 10 persAF patients. The mean processing time was 10.4 ± 1.5 min, which is adequate comparing to the normal electrophysiological (EP) procedure time (120∼180 min). Conclusions: A customized software platform capable of measuring different forms of spatiotemporal AEG analysis was implemented and used in clinical environment to guide persAF ablation. The modular nature of the platform will help electrophysiological studies in understanding of the underlying AF mechanisms

Minimizing discordances in automated classification of fractionated electrograms in human persistent atrial fibrillation

Ablation of persistent atrial fibrillation (persAF) targeting complex fractionated atrial electrograms (CFAEs) detected by automated algorithms has produced conflicting outcomes in previous electrophysiological studies. We hypothesize that the differences in these algorithms could lead to discordant CFAE classifications by the available mapping systems, giving rise to potential disparities in CFAE-guided ablation. This study reports the results of a head-to-head comparison of CFAE detection performed by NavX (St. Jude Medical) versus CARTO (Biosense Webster) on the same bipolar electrogram data (797 electrograms) from 18 persAF patients. We propose revised thresholds for both primary and complementary indices to minimize the differences in CFAE classification performed by either system. Using the default thresholds [NavX: CFEMean ≤ 120 ms; CARTO: ICL ≥ 7], NavX classified 70 % of the electrograms as CFAEs, while CARTO detected 36 % (Cohen’s kappa κ ≈ 0.3, P < 0.0001). Using revised thresholds found using receiver operating characteristic curves [NavX: CFE-Mean ≤ 84 ms, CFE-SD ≤ 47 ms; CARTO: ICL ≥ 4, ACI ≤ 82 ms, SCI ≤ 58 ms], NavX classified 45 %, while CARTO detected 42 % (κ ≈ 0.5, P < 0.0001). Our results show that CFAE target identification is dependent on the system and thresholds used by the electrophysiological study. The thresholds found in this work counterbalance the differences in automated CFAE classification performed by each system. This could facilitate comparisons of CFAE ablation outcomes guided by either NavX or CARTO in future works

In Silico 3D Simulations of Atrial Fibrillation Mechanisms

&lt;p&gt;Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in clinical practice, with a significant impact on patients' quality of life. In recent decades, clinical research has made considerable progress in seeking to understand the triggering and maintaining mechanisms of AF. With this progress, cardiac electrophysiology simulations have gained prominence in basic cardiology research. In this context, the present study aims to simulate the main mechanisms of AF on a 3D surface of the right atrium, including Ectopic Foci, Rotors, and Multiple Reentries. The openCARP (open-source simulator) was used, with the Courtemanche mathematical model for atrial cells and the monodomain model to represent the communication between myocardial cells in electrical activity. The simulations were visually classified using the openCARP Meshalyzer tool. Furthermore, qualitative analyses were performed, including observations of the wavefront morphology, initial conditions generating the mechanism, transmembrane potential signal shape, and patterns in fibrotic regions. Comparative analysis between some simulations was also addressed. In summary, these simulations support the theories of the simulated AF mechanisms and may uncover underlying patterns of arrhythmic conditions, providing insights for the study and understanding of this disease, with potential applications in clinical practice and future in silico studies.&lt;/p&gt

Visualizing Intracardiac Atrial Fibrillation Electrograms Using Spectral Analysis

Atrial fibrillation is the most common cardiac arrhythmia, and it is associated with increased risk of stroke, heart failure, and mortality. This work describes spectral analysis techniques that are being used in conjunction with visualization algorithms to help guide catheter ablation procedures that aim at treating patients with arrhythmia

Atrial Electrogram Complexity as a Clinical Instrument for Measuring Temporal Fractionation Variability during Atrial Fibrillation

Regions of the atria with complex fractionated atrial electrograms (CFEs) have been suggested to represent remodelled atrial substrate, and hence important sites for ablation in patients with persistent AF. However, temporal behaviour of complex fractionated atrial electrograms (CFEs) remains ill defined. In this study we introduce Negentropy (NegEn) as a measurement of electrogram (EGM) complexity and compare its use in measuring CFEs temporal behaviour with current algorithms based on time domain. [Taken from the Introduction

Three-dimensional dominant frequency mapping using autoregressive spectral analysis of atrial electrograms of patients in persistent atrial fibrillation

Background: Areas with high frequency activity within the atrium are thought to be ‘drivers’ of the rhythm in patients with atrial fibrillation (AF) and ablation of these areas seems to be an effective therapy in eliminating DF gradient and restoring sinus rhythm. Clinical groups have applied the traditional FFT-based approach to generate the three-dimensional dominant frequency (3D DF) maps during electrophysiology (EP) procedures but literature is restricted on using alternative spectral estimation techniques that can have a better frequency resolution that FFT-based spectral estimation. Methods: Autoregressive (AR) model-based spectral estimation techniques, with emphasis on selection of appropriate sampling rate and AR model order, were implemented to generate high-density 3D DF maps of atrial electrograms (AEGs) in persistent atrial fibrillation (persAF). For each patient, 2048 simultaneous AEGs were recorded for 20.478 s-long segments in the left atrium (LA) and exported for analysis, together with their anatomical locations. After the DFs were identified using AR-based spectral estimation, they were colour coded to produce sequential 3D DF maps. These maps were systematically compared with maps found using the Fourier-based approach. Results: 3D DF maps can be obtained using AR-based spectral estimation after AEGs downsampling (DS) and the resulting maps are very similar to those obtained using FFT-based spectral estimation (mean 90.23%). There were no significant differences between AR techniques (p=0.62). The processing time for AR-based approach was considerably shorter (from 5.44 to 5.05 s) when lower sampling frequencies and model order values were used. Higher levels of DS presented higher rates of DF agreement (sampling frequency of 37.5Hz). Conclusion: We have demonstrated the feasibility of using AR spectral estimation methods for producing 3D DF maps and characterised their differences to the maps produced using the FFT technique, offering an alternative approach for 3D DF compu- tation in human persAF studies

CAAos platform: an integrated platform for analysis of cerebral hemodynamics data

ObjectiveThe purpose of this article is to introduce the readers to the concept and structure of CAAos (Cerebral Autoregulation Assessment Open Source) platform, and provide evidence of its functionality.ApproachCAAos platform is a new open-source software research tool, developed in Python 3 language, that combines existing and novel methods for interactive visual inspection, batch processing and analysis of multichannel records. The platform is scalable, allowing for customization and inclusion of new tools.Main resultsCurrently CAAos platform is composed of two main modules, preprocessing (containing artefact removal, filtering and signal beat to beat extraction tools) and cerebral autoregulation (CA) analysis modules. Two methods for assessing CA have been implemented into CAAos platform: transfer function analysis (TFA) and autoregulation index (ARI). In order to provide validation of TFA and ARI estimates derived from CAAos platform, the results were compared with those derived from two other algorithms. Validation was performed using data from twenty-eight participants, corresponding to 13 acute ischemic stroke patients and 13 age- and sex-matched control subjects. Agreement between estimates was assessed by intraclass correlation coefficient and Bland-Altman analysis. No significant statistical difference between algorithms was found. Moreover, there was an excellent correspondence between the curves of all parameters analysed, with intraclass correlation coefficient ranging from 0.98 (95%CI 0.976-0.999) to 1.00 (95%CI 1 -1). The mean differences revealed a very small magnitude bias indicating an excellent agreement between the estimates.SignificanceAs open-source software, the source code for the software is freely available for non-commercial use, reducing barriers to performing CA analysis, allowing inspection of the inner-workings of the algorithms, and facilitating networked activities with common standards. CAAos platform is a tailored software solution for the scientific community in the cerebral hemodynamic field and contributes to increasing use and reproducibility of CA assessment

Analysis of QRS-T Subtraction in Unipolar Atrial Fibrillation Electrograms

This paper presents a QRS-T subtraction approach for atrial fibrillation (AF) intracardiac atrial electrograms (AEG). It also presents a comparison between the proposed method and two alternative ventricular subtraction techniques: average beat subtraction (ABS) using a fixed length window and an approach based on flat interpolation for QRS cancellation. Areas of the atrium close to the mitral valve showed stronger ventricular influence on the AEGs when compared with the remaining atrial regions. Ventricular influence affects the spectral power distribution of the AEG and can also affect the estimation of the dominant frequency unless the whole ventricular activity influence (QRS-T) is removed. The average power after QRS-T subtraction is significantly reduced for frequencies above 10 Hz (mostly associated with QRS complexes), as well as for frequencies between 3 and 5.5 Hz, (mostly related to T waves). The results indicate that the proposed approach removes ventricular influence on the AF AEGs better than the QRS cancellation method. Spectral analysis showed that both the ABS and the proposed method do well and no method should be preferred to the other. In the time domain, the proposed approach is matched to the lengths and timings of onset and offset for individual QRS-T segments while the ABS approach uses an arbitrary length around the QRS for the pattern used for QRS-T removal