Abstract
Measurements of cardiac conduction velocity provide valuable functional and structural insight into the initiation and perpetuation of cardiac arrhythmias, in both a clinical and laboratory context. The interpretation of activation wavefronts and their propagation can identify mechanistic properties of a broad range of electrophysiological pathologies. However, the sparsity, distribution and uncertainty of recorded data make accurate conduction velocity calculation difficult. A wide range of mathematical approaches have been proposed for addressing this challenge, often targeted towards specific data modalities, species or recording environments. Many of these algorithms require identification of activation times from electrogram recordings which themselves may have complex morphology or low signal-to-noise ratio. This paper surveys algorithms designed for identifying local activation times and computing conduction direction and speed. Their suitability for use in different recording contexts and applications is assessed.
Highlights
Cardiac conduction velocity (CV) describes the speed and direction of propagation of the action potential wavefront through myocardium
The approach is primarily targeted at identifying activation times during fibrillatory activity where multi-deflection complexes, whose morphologies vary over time, are present
Finite difference approaches to computing conduction velocity are often susceptible to noise in the local activation time estimation or adjacent grid points having identical activation times, leading to spurious distortions of the conduction velocity field
Summary
Cardiac conduction velocity (CV) describes the speed and direction of propagation of the action potential wavefront through myocardium It can provide important quantitative electrophysiological information about the underlying tissue microarchitecture and is widely used in both laboratory [1,2] and clinical electrophysiological studies [3,4] to infer properties of the myocardial substrate and to identify potential mechanisms for arrhythmogenesis [5,6,7]. A catheter consisting of three electrodes arranged in an equilateral triangle around a fourth reference electrode allows the estimation of the direction of propagation and conduction speed based on the differences in measured activation times [59]. This paper reviews currently available LAT and CV algorithms, assesses the applicability of each technique for various recording modalities, and recommends the most suitable technique for various datasets
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