title: Estimation of Purkinje trees from electro-anatomical mapping of the left ventricle using minimal cost geodesics.
abstract: The electrical activation of the heart is a complex physiological process that is essential for the understanding of several cardiac dysfunctions, such as ventricular tachycardia (VT). Nowadays, patient-specific activation times on ventricular chambers can be estimated from electro-anatomical maps, providing crucial information to clinicians for guiding cardiac radio-frequency ablation treatment. However, some relevant electrical pathways such as those of the Purkinje system are very difficult to interpret from these maps due to sparsity of data and the limited spatial resolution of the system. We present here a novel method to estimate these fast electrical pathways from the local activations maps (LATs) obtained from electro-anatomical maps. The location of Purkinje-myocardial junctions (PMJs) is estimated considering them as critical points of a distance map defined by the activation maps, and then minimal cost geodesic paths are computed on the ventricular surface between the detected junctions. Experiments to validate the proposed method have been carried out in simplified and realistic simulated data, showing good performance on recovering the main characteristics of simulated Purkinje networks (e.g. PMJs). A feasibility study with real cases of fascicular VT was also performed, showing promising results.
authors.affiliation: Physense, Universitat Pompeu Fabra, Roc de Boronat 138, 08018 Barcelona, Spain. Electronic address: ruben.cardenes@upf.edu.
authors.forename: Rubén
authors.initials: R
authors.lastname: Cárdenes
authors.affiliation: Computational Multiscale Physiology Lab (CoMMLab), Department of Computer Science, Universitat de Valencia, 46100 Valencia, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Sebastian
authors.affiliation: Physense, Universitat Pompeu Fabra, Roc de Boronat 138, 08018 Barcelona, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Soto-Iglesias
authors.affiliation: Arrhythmia Section, Cardiology Department, Thorax Institute, Hospital Clínic, Universitat de Barcelona, Villaroel 107, 08036 Barcelona, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Berruezo
authors.affiliation: Physense, Universitat Pompeu Fabra, Roc de Boronat 138, 08018 Barcelona, Spain.
authors.forename: Oscar
authors.initials: O
authors.lastname: Camara
mesh_terms: D000200:Action Potentials / Q000502:physiology*; D000465:Algorithms; D018780:Body Surface Potential Mapping / Q000379:methods*; D005240:Feasibility Studies; D006352:Heart Ventricles / Q000033:anatomy & histology*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D011690:Purkinje Fibers / Q000033:anatomy & histology* / Q000502:physiology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016277:Ventricular Function, Left / Q000502:physiology*
keywords: Cardiac arrhythmias; Electro-anatomical mapping; Fascicular ventricular tachycardia; Fast marching; Minimal cost geodesic paths; Purkinje system; Singular points