Prediction of the Exit Site of Ventricular Tachycardia Based on Different ECG Lead Systems
Résumé
The effectiveness of a computer-based method for
localization of arrhythmia exit sites was studied.
The proposed algorithm works on any set of 3 or more
ECG leads. The QRS complex integral of an ectopic beat
is reduced to principal components treated as coordinates
of the exit site in ECG space and then projected to real
space by a linear transformation. The accuracy of the
method was tested on 5 patient-tailored models of human
heart and torso. For each model ~500 simulations were
run, each for different stimulus location. All locations
were then estimated from simulated surface ECGs and
method accuracy was investigated.
The algorithm performed better for the left ventricle
than for the right ventricle. The group mean absolute and
relative (to a neighboring stimulation site) localization
errors in millimeters were: 11.5 (SD=2.5), 2.6 (SD=0.5)
for the 252-lead ECG; 12.2 (SD=2.7), 2.7 (SD=0.5) for
the 12-lead ECG; and 11.7 (SD=2.4), 2.7 (SD=0.5) for
the Frank VCG.
This study suggest that the proposed method can
predict exit sites with a precision in the order of a
centimeter. Low values of error for neighbouring
activation sites suggest opportunity for algorithm
improvement. The use of vectorcardiographic leads is
enough to obtain a precision comparable to a 252-lead
ECG.
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