title: Identification of cardiac rhythm features by mathematical analysis of vector fields.
abstract: Automated techniques for locating cardiac arrhythmia features are limited, and cardiologists generally rely on isochronal maps to infer patterns in the cardiac activation sequence during an ablation procedure. Velocity vector mapping has been proposed as an alternative method to study cardiac activation in both clinical and research environments. In addition to the visual cues that vector maps can provide, vector fields can be analyzed using mathematical operators such as the divergence and curl. In the current study, conduction features were extracted from velocity vector fields computed from cardiac mapping data. The divergence was used to locate ectopic foci and wavefront collisions, and the curl to identify central obstacles in reentrant circuits. Both operators were applied to simulated rhythms created from a two-dimensional cellular automaton model, to measured data from an in situ experimental canine model, and to complex three-dimensional human cardiac mapping data sets. Analysis of simulated vector fields indicated that the divergence is useful in identifying ectopic foci, with a relatively small number of vectors and with errors of up to 30 degrees in the angle measurements. The curl was useful for identifying central obstacles in reentrant circuits, and the number of velocity vectors needed increased as the rhythm became more complex. The divergence was able to accurately identify canine in situ pacing sites, areas of breakthrough activation, and wavefront collisions. In data from human arrhythmias, the divergence reliably estimated origins of electrical activity and wavefront collisions, but the curl was less reliable at locating central obstacles in reentrant circuits, possibly due to the retrospective nature of data collection. The results indicate that the curl and divergence operators applied to velocity vector maps have the potential to add valuable information in cardiac mapping and can be used to supplement human pattern recognition.
authors.affiliation: Department of Biomedical Engineering, Boston University, Boston, MA 02215, USA. Tamara.Fitzgerald@yale.edu
authors.forename: Tamara N
authors.initials: TN
authors.lastname: Fitzgerald
authors.forename: Dana H
authors.initials: DH
authors.lastname: Brooks
authors.forename: John K
authors.initials: JK
authors.lastname: Triedman
mesh_terms: D000465:Algorithms; D000818:Animals; D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000503:physiopathology*; D003198:Computer Simulation; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D004285:Dogs; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008955:Models, Cardiovascular; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014672:Vectorcardiography / Q000379:methods*