Abstract
Intracardiac electrograms (EGMs) are electrical signals measured within the chambers of the heart, which can be used to locate abnormal cardiac tissue and guide catheter ablations to treat cardiac arrhythmias. EGMs may contain large amounts of uncertainty and irregular variations, which pose significant challenges in data analysis. This study aims to introduce a statistical approach to account for the data uncertainty while analyzing EGMs for abnormal electrical impulse identification. The activation order of catheter sensors was modeled with a multinomial distribution, and maximum likelihood estimations were done to track the electrical wave conduction path in the presence of uncertainty. Robust optimization was performed to locate the electrical impulses based on the local conduction velocity and the geodesic distances between catheter sensors. The proposed algorithm can identify the focal sources when the electrical conduction is initiated by irregular electrical impulses and involves wave collisions, breakups, and spiral waves. The statistical modeling framework can efficiently deal with data uncertainties and provide a reliable estimation of the focal source locations. This shows the great potential of a statistical approach for the quantitative analysis of the stochastic activity of electrical waves in cardiac disorders and suggests future investigations integrating statistical methods with a deterministic geometry-based method to achieve advanced diagnostic performance.
Highlights
Cardiac disease is the leading cause of death in U.S and in the world [1]
Supraventricular Arrhythmias such as Atrial Fibrillation (AF) and Atrial Flutter are very common irregular heart rhythms [2]. This group of conditions occurs when abnormal electrical impulses take the control of the heart rhythm from the normal sinus node pacemaker and initiate rapid and irregular activities in different areas of atria, which cause the atria to quiver [3]
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Summary
Cardiac arrhythmia is a common cardiac disorder caused by irregular heartbeats initiated in different chambers of the heart. Supraventricular Arrhythmias such as Atrial Fibrillation (AF) and Atrial Flutter are very common irregular heart rhythms [2]. This group of conditions occurs when abnormal electrical impulses take the control of the heart rhythm from the normal sinus node pacemaker and initiate rapid and irregular activities in different areas of atria, which cause the atria to quiver [3]. Treatments of supraventricular arrhythmias include the antiarrhythmic medication to control heart rate and rhythm and prevent blood clotting, as well as radiofrequency catheter ablation (RFA) that ablates abnormal electrical pathways in atrial tissue. RFA is guided by the intracardiac electrograms (EGMs), where the recordings are analyzed to identify the drivers (rotor, foci, and breakthrough) that cause and maintain abnormal electrical activities
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