Epicardial Mapping from Intracoronary Catheters

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Epicardial Mapping from Intracoronary Catheters

• Rob MacLeod,
• Richard Kuenzler, Quan Ni, Bruno Taccardi, and
  Bob Lux

NEH Cardiovascular Research and Training
Institute (CVRTI), U of Utah
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Cardiac Mapping

• Coverage
• Surface or volume
• Sampling Density

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Catheter Mapping

• Epicardial
• Endocardial
• Venous

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The Questions

• What are catheter electrograms?
• Can they provide mapping data?

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Catheter Measurements

• Acute dog preparation
• Cardima 4-16 pole catheters
• High resolution epicardial plaque

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Electrogram Comparison
20
10
V mV
0
-10
-20
-30
-40
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Statistical Comparison
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Interpolation
Original
Hardys
Laplacian
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Interpolation
Original
Hardys
Laplacian
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Statistical Estimation
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Interpolation vs. Estimation
Statistical Estimation
Original
Hardys
Laplacian
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Interpolation vs. Estimation
Statistical Estimation
Original
Hardys
Laplacian
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Electrode Spacing
Original
Estimated 41 leads (4 mm spacing)
Estimated 21 leads (8 mm spacing)
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Test Geometry
GCV
CS
GCV
Coronary Circulation
MCV
LVP
Surrogate Catheters
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Resubstitution Protocol
Training Data
Test Data
Experiment 1
Experiment 3
Experiment 2
Experiment 4
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Leave-One-Map-Out Protocol
Training Data
Test Data
Experiment 1
Experiment 3
Experiment 2
Experiment 4
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Leave-One-Experiment-Out Protocol
Training Data
Test Data
Experiment 1
Experiment 2
Experiment 4
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Training Protocols

• Resubstitution
• test data included in training
• sets the standard for a given database
• Leave one map out
• test data from same experiment as training
• the intermittent bad lead case
• Leave one experiment out
• test data from different experiment
• clinically most relevant condition

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LV Pacing
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Anterior Pacing
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Apical Pacing
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Apical Pacing
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Posterior Pacing
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Posterior Pacing
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Effect of of Leads
Relative Error
Mean

• leads evenly spaced
• N153 maps

L-experiment
L-map
Resubstitution
Std. Dev.
5
10
15
20
25
30
35
40
Catheter Leads
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Highlight infarct case

• Database included normal hearts
• Test set from infarcted heart

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Current Research

• Acquire larger database
• Variety of activation sequences
• Range of interventions
• Evaluate other estimation approaches
• Evaluate other basis functions
• Merge estimation with interpolation