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Theoretical assessment of a repolarization time marker based on the intracardiac bipolar electrogram

Orini, M; Van Duijvenboden, S; Srinivasan, N; Finlay, M; Taggart, P; Lambiase, PD; (2017) Theoretical assessment of a repolarization time marker based on the intracardiac bipolar electrogram. In: Computing in Cardiology 2017. Computing in Cardiology: Rennes, France. Green open access

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Abstract

The spatio-temporal organization of cardiac repolarization modulates the vulnerability to dangerous ventricular arrhythmias. Methodologies that provide accurate assessment of cardiac repolarization are of primary importance for a better understanding of cardiac electrophysiology and represent a potentially useful tool for clinical applications. The most commonly used repolarization time (RT) marker from extracellular recordings is derived from the unipolar electrogram (UEG). However, far field potentials and remote activity may in certain conditions bias this marker. In this paper, a RT marker based on the bipolar electrogram (BEG) is proposed. An analytical expression of the BEG based on a simple model of the cardiac extracellular potential is derived. According to the proposed analytical framework the BEG exhibits a repolarization wave whose extremum (maximum or minimum) corresponds to the average of the local RTs at the two electrodes of the bipole. The amplitude of this extremum is a function of the steepness of phase 3 of the action potentials, inter-electrode distance, conduction velocity and direction of wave-back propagation. A simulation study based on this analytical framework showed that for noisy to good signal quality (SNR of the UEG ≥ 10 dB), and for a typical inter-electrode distance of 2 mm, conduction velocity between 0.2 and 0.6 m/s, and an angle between conduction direction and the inter-electrode axis ≤ π/4, the median absolute error was lower than 6.8 ms while the median linear correlation between estimated and theoretical RT was higher than 0.91. Examples of RT derived from BEG recorded in a structurally normal heart in both the right and left ventricles demonstrate that the proposed procedure is feasible in human in-vivo studies.

Type: Proceedings paper
Title: Theoretical assessment of a repolarization time marker based on the intracardiac bipolar electrogram
Event: 44th Computing in Cardiology Conference (CinC)
Location: Rennes, France
Dates: 24 September 2017 - 27 September 2017
Open access status: An open access version is available from UCL Discovery
DOI: 10.22489/CinC.2017.220-241
Publisher version: http://dx.doi.org/10.22489/CinC.2017.220-241
Language: English
Additional information: © 2017 IEEE Computer Society. All rights reserved. CinC has been an open-access publication, in which copyright in each article is held by its authors, who grant permission to copy and redistribute their work with attribution, under the terms of the Creative Commons Attribution License. (https://creativecommons.org/licenses/by/2.5/)
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Clinical Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine > MRC Unit for Lifelong Hlth and Ageing
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Med Phys and Biomedical Eng
URI: https://discovery.ucl.ac.uk/id/eprint/10047006
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