Interactive teaching of medical 3D cardiac anatomy: atrial anatomy enhanced by ECG and 3D visualization.

The most commonly applied way of teaching students to convey the foundations of human anatomy and physiology involves textbooks and lectures. This way of transmitting knowledge causes difficulties for students, especially in the context of three-dimensional imaging of organ structures, and as a consequence translates into difficulties with imagining them. Even despite the rapid uptake of knowledge dissemination provided by online materials, including courses and webinars, there is a clear need for learning programs featuring first-hand immersive experiences tailored to suit individual study paces.

Non-invasive localization of the ventricular excitation origin without patient-specific geometries using deep learning.

Cardiovascular diseases account for 17 million deaths per year worldwide. Of these, 25% are categorized as sudden cardiac death, which can be related to ventricular tachycardia (VT). This type of arrhythmia can be caused by focal activation sources outside the sinus node.

His-Optimized Cardiac Resynchronization Therapy With Ventricular Fusion Pacing for Electrical Resynchronization in Heart Failure.

Objectives: This study sought to evaluate the effectiveness of His-optimized cardiac resynchronization therapy (HOT-CRT) for reducing left ventricular activation time (LVAT) compared to His bundle pacing (HBP) and biventricular (BiV) pacing (including multipoint pacing [MPP]), using electrocardiographic (ECG) imaging.

Background: HBP may correct bundle branch block (BBB) and has shown encouraging results for providing CRT. However, HBP does not correct BBB in all patients and may be combined with univentricular or BiV fusion pacing to deliver HOT-CRT to maximize resynchronization.

Combination of lead-field theory with cardiac vector direction: ECG imaging of septal ventricular activation.

Background: Despite the tremendous progress recently reported in ECG imaging (ECGI), some fundamental challenges are still hindering this non-invasive technology from meeting rising clinical expectations. In the present work, we address one of the major ECGI shortcomings in reconstruction of ventricular activation - the limited accuracy of endocardial and particularly septal mapping.

Methods: Ten CRT patients (five female, median (min-max) age - 61 (27-78) years) with previously implanted CRT devices underwent ECGI with isolated right ventricular (RV) pacing.

ECG Adapted Fastest Route Algorithm to Localize the Ectopic Excitation Origin in CRT Patients.

Although model-based solution strategies for the ECGI were reported to deliver promising clinical results, they strongly rely on some a priori assumptions, which do not hold true for many pathological cases. The fastest route algorithm (FRA) is a well-established method for noninvasive imaging of ectopic activities. It generates test activation sequences on the heart and compares the corresponding test body surface potential maps (BSPMs) to the measured ones.

Solving the Inverse Problem of Electrocardiography on the Endocardium Using a Single Layer Source.

The inverse problem of electrocardiography consists in reconstructing cardiac electrical activity from given body surface electrocardiographic measurements. Despite tremendous progress in the field over the last decades, the solution of this problem in terms of electrical potentials on both epi- and the endocardial heart surfaces with acceptable accuracy remains challenging. This paper presents a novel numerical approach aimed at improving the solution quality on the endocardium.

ECGI in atrial fibrillation: A clinician's wish list.

Have we a challenge of credibility in the invasive treatment of atrial fibrillation (AFIB)? The incidence of AFIB in the European Union (EU) is about 600,000 cases per year, while only 100,000 get an invasive treatment with a failure rate of close to 40%. Those that remain in AFIB need two times more hospitalizations and three times more re-hospitalizations. AFIB accounts for over 1% of the EU health care costs.

Assessment of the equivalent dipole layer source model in the reconstruction of cardiac activation times on the basis of BSPMs produced by an anisotropic model of the heart.

Promising results have been reported in noninvasive estimation of cardiac activation times (AT) using the equivalent dipole layer (EDL) source model in combination with the boundary element method (BEM). However, the assumption of equal anisotropy ratios in the heart that underlies the EDL model does not reflect reality. In the present study, we quantify the errors of the nonlinear AT imaging based on the EDL approximation.

The Consortium for Electrocardiographic Imaging.

Electrocardiographic imaging (ECGI) has recently gained attention as a viable diagnostic tool for reconstructing cardiac electrical activity in normal hearts as well as in cardiac arrhythmias. However, progress has been limited by the lack of both standards and unbiased comparisons of approaches and techniques across the community, as well as the consequent difficulty of effective collaboration across research groups..

ECG imaging of ventricular tachycardia: evaluation against simultaneous non-contact mapping and CMR-derived grey zone.

ECG imaging is an emerging technology for the reconstruction of cardiac electric activity from non-invasively measured body surface potential maps. In this case report, we present the first evaluation of transmurally imaged activation times against endocardially reconstructed isochrones for a case of sustained monomorphic ventricular tachycardia (VT). Computer models of the thorax and whole heart were produced from MR images.

Influence of Modeling Errors on the Initial Estimate for Nonlinear Myocardial Activation Times Imaging Calculated With Fastest Route Algorithm.

Noninvasive reconstruction of cardiac electrical activity has a great potential to support clinical decision making, planning, and treatment. Recently, significant progress has been made in the estimation of the cardiac activation from body surface potential maps (BSPMs) using boundary element method (BEM) with the equivalent double layer (EDL) as a source model. In this formulation, noninvasive assessment of activation times results in a nonlinear optimization problem with an initial estimate calculated with the fastest route algorithm (FRA).

Experimental Data and Geometric Analysis Repository-EDGAR.

Introduction: The "Experimental Data and Geometric Analysis Repository", or EDGAR is an Internet-based archive of curated data that are freely distributed to the international research community for the application and validation of electrocardiographic imaging (ECGI) techniques. The EDGAR project is a collaborative effort by the Consortium for ECG Imaging (CEI, ecg-imaging.org), and focused on two specific aims.

Automatic camera-based identification and 3-D reconstruction of electrode positions in electrocardiographic imaging.

Electrocardiographic imaging (ECG imaging) is a method to depict electrophysiological processes in the heart. It is an emerging technology with the potential of making the therapy of cardiac arrhythmia less invasive, less expensive, and more precise. A major challenge for integrating the method into clinical workflow is the seamless and correct identification and localization of electrodes on the thorax and their assignment to recorded channels.

Binary optimization for source localization in the inverse problem of ECG.

The goal of ECG-imaging (ECGI) is to reconstruct heart electrical activity from body surface potential maps. The problem is ill-posed, which means that it is extremely sensitive to measurement and modeling errors. The most commonly used method to tackle this obstacle is Tikhonov regularization, which consists in converting the original problem into a well-posed one by adding a penalty term.