Abstract
Electrocardiography provides some information useful for ischemic diagnosis. However, more recently there has been substantial growth in the area of ECG imaging, which by solving the inverse problem of electrocardiography aims to produce high-resolution mapping of the electrical and magnetic dynamics of the heart. Most inverse studies use the full resolution of the body surface potential (BSP) to reconstruct the epicardial potentials, however using a limited number of torso electrodes to interpolate the BSP is more clinically relevant and has an important effect on the reconstruction which must be quantified. A circular ischemic lesion on the right ventricle lateral wall 27 mm in radius is reconstructed using three Tikhonov methods along with 6 different electrode configurations ranging from 32 leads to 1,024 leads. The 2nd order Tikhonov solution performed the most accurately (~80% lesion identified) followed by the 1st (~50% lesion identified) and then the 0 order Tikhonov solution performed the worst with a maximum of ~30% lesion identified regardless of how many leads were used. With an increasing number of leads the solution produces less error, and the error becomes more localised around the lesion for all three regularisation methods. In noisy conditions, the relative performance gap of the 1st and 2nd order Tikhonov solutions was reduced, and determining an accurate regularisation parameter became relatively more difficult. Lesions located on the left ventricle walls were also able to be identified but comparatively to the right ventricle lateral wall performed marginally worse with lesions located on the interventricular septum being able to be indicated by the reconstructions but not successfully identified against the error. The quality of reconstruction was found to decrease as the lesion radius decreased, with a lesion radius of <20 mm becoming difficult to correctly identify against the error even when using >512 torso electrodes.
Highlights
Cardiovascular disease is the most common cause of morbidity and mortality in developed countries
In this work we aim to evaluate the use of ECG imaging (ECGI) imaging to detect ischemic lesion using a virtual ventricle-torso model
When lead numbers are smaller the 2nd order Tikhonov solution clearly outperforms the 1st order solution, as the lead number increases the difference in mean relative difference mean star (RDMS) between solutions would seem to decrease
Summary
Cardiovascular disease is the most common cause of morbidity and mortality in developed countries. Atrial arrhythmias are more common, ventricular arrhythmias are the more lethal arrhythmias accounting for around 50% of all sudden cardiac deaths (Huikuri et al, 2001). ECGI of Ventricular Ischemia (Ghuran and Camm, 2001), and early and effective diagnosis of myocardial ischemia is most essential for proper treatment of patients with cardiac ischemia in order to save their lives. Electrocardiography (ECG) provides some information useful for ischemic diagnosis. A standard 12-lead ECG is widely used to detect abnormalities in the heart electrical activity, provides a convenient way for detection of myocardial ischemia (Sejersten et al, 2007). Due to a low-level reflection of spatial-temporal electrophysiological dynamics of the heart of the 12-lead ECG, there are some limitations in its use for ischemic diagnosis, especially in the detection of the ischemic lesion in the heart (Alday et al, 2016)
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