Myocardial infarction (MI) is among the leading causes of death in the United States. It is imperative to identify and characterize MIs for timely delivery of life-saving medical interventions. Cardiac electrical activity propagates in space and evolves over time. Traditional works focus on the analysis of time-domain ECG (e.g., 12-lead ECG) on the body surface for the detection of MIs, but tend to overlook spatiotemporal dynamics in the heart. Body surface potential mappings (BSPMs) provide high-resolution distribution of electric potentials over the entire torso, and therefore provide richer information than 12-lead ECG. However, BSPM are available on the body surface. Clinicians are in need of a closer look of the electric potentials in the heart to investigate cardiac pathology and optimize treatment strategies. In this paper, we applied the method of spatiotemporal inverse ECG (ST-iECG) modeling to map electrical potentials from the body surface to the heart, and then characterize the location and extent of MIs by investigating the reconstructed heart-surface electrograms. First, we investigate the impact of mesh resolution on the inverse ECG modeling. Second, we solve the inverse ECG problem and reconstruct heart-surface electrograms using the ST-iECG model. Finally, we propose a wavelet-clustering method to investigate the pathological behaviors of heart-surface electrograms, and thereby characterize the extent and location of MIs. The proposed methodology is evaluated and validated with real data of MIs from human subjects. Experimental results show that negative QRS waves in heart-surface electrograms indicate potential regions of MI, and the proposed ST-iECG model yields superior characterization results of MIs on the heart surface over existing methods.

译文

:心肌梗塞(MI)是美国的主要死亡原因之一。当务之急是识别和表征心梗,以及时提供挽救生命的医疗干预措施。心脏电活动在空间中传播并随时间发展。传统工作着重于分析体表上的时域心电图(例如12导联心电图)以检测心梗,但往往忽略了心脏的时空动态。体表电位映射(BSPM)可在整个躯干上提供高分辨率的电位分布,因此比12导联ECG可以提供更丰富的信息。但是,BSPM可以在体表上使用。临床医生需要仔细查看心脏中的电势,以研究心脏病理并优化治疗策略。在本文中,我们应用时空逆心电图(ST-iECG)建模方法来绘制从体表到心脏的电势,然后通过研究重建的心脏表面电描记图来描述MI的位置和范围。首先,我们研究了网格分辨率对反ECG建模的影响。其次,我们解决反心电图问题,并使用ST-iECG模型重建心脏表面电图。最后,我们提出了一种小波聚类方法来研究心脏表面电描记图的病理行为,从而表征心梗的程度和位置。利用来自人类受试者的MI的真实数据对提出的方法进行评估和验证。实验结果表明,心脏表面电描记图上的负QRS波指示了MI的潜在区域,与现有方法相比,所提出的ST-iECG模型在心脏表面产生了MI的更好的表征结果。

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