title: Data-driven estimation of cardiac electrical diffusivity from 12-lead ECG signals.
abstract: Diagnosis and treatment of dilated cardiomyopathy (DCM) is challenging due to a large variety of causes and disease stages. Computational models of cardiac electrophysiology (EP) can be used to improve the assessment and prognosis of DCM, plan therapies and predict their outcome, but require personalization. In this work, we present a data-driven approach to estimate the electrical diffusivity parameter of an EP model from standard 12-lead electrocardiograms (ECG). An efficient forward model based on a mono-domain, phenomenological Lattice-Boltzmann model of cardiac EP, and a boundary element-based mapping of potentials to the body surface is employed. The electrical diffusivity of myocardium, left ventricle and right ventricle endocardium is then estimated using polynomial regression which takes as input the QRS duration and electrical axis. After validating the forward model, we computed 9500 EP simulations on 19 different DCM patients in just under three seconds each to learn the regression model. Using this database, we quantify the intrinsic uncertainty of electrical diffusion for given ECG features and show in a leave-one-patient-out cross-validation that the regression method is able to predict myocardium diffusion within the uncertainty range. Finally, our approach is tested on the 19 cases using their clinical ECG. 84% of them could be personalized using our method, yielding mean prediction errors of 18.7ms for the QRS duration and 6.5° for the electrical axis, both values being within clinical acceptability. By providing an estimate of diffusion parameters from readily available clinical data, our data-driven approach could therefore constitute a first calibration step toward a more complete personalization of cardiac EP.
authors.affiliation: Siemens Corporate Technology, Imaging and Computer Vision, Princeton, NJ, USA; Computer Aided Medical Procedures, Technische Universität München, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Zettinig
authors.affiliation: Siemens Corporate Technology, Imaging and Computer Vision, Princeton, NJ, USA. Electronic address: tommaso.mansi@siemens.com.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Mansi
authors.affiliation: Siemens Corporate Technology, Imaging and Computer Vision, Princeton, NJ, USA; Pattern Recognition Lab, Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany.
authors.forename: Dominik
authors.initials: D
authors.lastname: Neumann
authors.affiliation: Siemens Corporate Technology, Imaging and Computer Vision, Princeton, NJ, USA.
authors.forename: Bogdan
authors.initials: B
authors.lastname: Georgescu
authors.affiliation: Siemens Corporate Technology, Imaging and Computer Vision, Princeton, NJ, USA.
authors.forename: Saikiran
authors.initials: S
authors.lastname: Rapaka
authors.affiliation: Siemens Corporate Technology, Imaging and Computer Vision, Princeton, NJ, USA; Pattern Recognition Lab, Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Seegerer
authors.affiliation: Heidelberg University Hospital, Heidelberg, Germany.
authors.forename: Elham
authors.initials: E
authors.lastname: Kayvanpour
authors.affiliation: Heidelberg University Hospital, Heidelberg, Germany.
authors.forename: Farbod
authors.initials: F
authors.lastname: Sedaghat-Hamedani
authors.affiliation: Heidelberg University Hospital, Heidelberg, Germany.
authors.forename: Ali
authors.initials: A
authors.lastname: Amr
authors.affiliation: Heidelberg University Hospital, Heidelberg, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Haas
authors.affiliation: Heidelberg University Hospital, Heidelberg, Germany.
authors.forename: Henning
authors.initials: H
authors.lastname: Steen
authors.affiliation: Heidelberg University Hospital, Heidelberg, Germany.
authors.forename: Hugo
authors.initials: H
authors.lastname: Katus
authors.affiliation: Heidelberg University Hospital, Heidelberg, Germany.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Meder
authors.affiliation: Computer Aided Medical Procedures, Technische Universität München, Germany.
authors.forename: Nassir
authors.initials: N
authors.lastname: Navab
authors.affiliation: Siemens Corporate Technology, Imaging and Computer Vision, Princeton, NJ, USA.
authors.forename: Ali
authors.initials: A
authors.lastname: Kamen
authors.affiliation: Siemens Corporate Technology, Imaging and Computer Vision, Princeton, NJ, USA.
authors.forename: Dorin
authors.initials: D
authors.lastname: Comaniciu
mesh_terms: D018780:Body Surface Potential Mapping / Q000379:methods*; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis* / Q000503:physiopathology*; D003198:Computer Simulation; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D004562:Electrocardiography / Q000379:methods*; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008955:Models, Cardiovascular; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: Cardiac electrophysiology; Electrocardiogram; Lattice-Boltzmann method; Statistical learning; Uncertainty quantification