1
|
Li QH, Van Nieuwenhuyse E, Xia YX, Pan JT, Duytschaever M, Knecht S, Vandersickel N, Zhou C, Panfilov AV, Zhang H. Finding type and location of the source of cardiac arrhythmias from the averaged flow velocity field using the determinant-trace method. Phys Rev E 2021; 104:064401. [PMID: 35030872 DOI: 10.1103/physreve.104.064401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 11/05/2021] [Indexed: 06/14/2023]
Abstract
Life threatening cardiac arrhythmias result from abnormal propagation of nonlinear electrical excitation waves in the heart. Finding the locations of the sources of these waves remains a challenging problem. This is mainly due to the low spatial resolution of electrode recordings of these waves. Also, these recordings are subjected to noise. In this paper, we develop a different approach: the AFV-DT method based on an averaged flow velocity (AFV) technique adopted from the analysis of optical flows and the determinant-trace (DT) method used for vector field analysis of dynamical systems. This method can find the location and determine all important types of sources found in excitable media such as focal activity, spiral waves, and waves rotating around obstacles. We test this method on in silico data of various wave excitation patterns obtained using the Luo-Rudy model for cardiac tissue. We show that the method works well for data with low spatial resolutions (up to 8×8) and is stable against noise. Finally, we apply it to two clinical cases and show that it can correctly identify the arrhythmia type and location. We discuss further steps on the development and improvement of this approach.
Collapse
Affiliation(s)
- Qi-Hao Li
- Department of Physics, Zhejiang University, Hangzhou 310027, China
| | | | - Yuan-Xun Xia
- Department of Physics, Zhejiang University, Hangzhou 310027, China
| | - Jun-Ting Pan
- Ocean College, Zhejiang University, Zhoushan 316021, China
| | | | | | - Nele Vandersickel
- Department of Physics and Astronomy, Ghent University, Ghent 9000, Belgium
| | - Changsong Zhou
- Department of Physics, Zhejiang University, Hangzhou 310027, China
- Department of Physics, Centre for Nonlinear Studies and Beijing-Hong Kong-Singapore Joint Centre for Nonlinear and Complex Systems (Hong Kong), Institute of Computational and Theoretical Studies, Hong Kong Baptist University, Kowloon Tong, Hong Kong
- Research Centre, HKBU Institute of Research and Continuing Education, Shenzhen 518057, China
- Beijing Computational Science Research Center, Beijing 100084, China
| | - Alexander V Panfilov
- Department of Physics and Astronomy, Ghent University, Ghent 9000, Belgium
- Laboratory of Computational Biology and Medicine, Ural Federal University, Ekaterinburg 620002, Russia
- World-Class Research Center "Digital biodesign and personalized healthcare," Sechenov University, Moscow 119146, Russia
| | - Hong Zhang
- Department of Physics, Zhejiang University, Hangzhou 310027, China
| |
Collapse
|
2
|
Oesterle A, Lee AC, Voskoboinik A, Moss JD, Vedantham V, Walters TE, Lee BK, Tseng ZH, Gerstenfeld EP, Scheinman MM. Electrophysiologic approach to diagnosis and ablation of patients with permanent junctional reciprocating tachycardia associated with complex anatomy and/or physiology. J Cardiovasc Electrophysiol 2020; 31:3232-3242. [PMID: 33107135 DOI: 10.1111/jce.14788] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 10/04/2020] [Accepted: 10/11/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Permanent junctional reciprocating tachycardia (PJRT) is a rare supraventricular tachycardia (SVT), typically involving a single decremental posteroseptal accessory pathway (AP). METHODS Four patients with long RP SVT underwent electrophysiology (EP) study and ablation. The cases were reviewed. RESULTS Case 1 recurred despite 3 prior ablations at the site of earliest retrograde atrial activation during orthodromic reciprocating tachycardia (ORT). Mapping during a repeat EP study demonstrated a prepotential in the coronary sinus (CS). Ablation over the earliest atrial activation in the CS resulted in dissociation of the potential from the atrium during sinus rhythm. The potential was traced back to the CS os and ablated. Case 2 underwent successful ablation at 6 o'clock on the mitral annulus (MA). ORT recurred and successful ablation was performed at 1 o'clock on the MA. Case 3 had tachycardia with variation in both V-A and A-H intervals which precluded the use of usual maneuvers so we used simultaneous atrial and ventricular pacing and introduced a premature atrial contraction with a closely coupled premature ventricular contraction. Case 4 had had two prior atrial fibrillation ablations with continued SVT over a decremental atrioventricular bypass tract that was successfully ablated at 5 o'clock on the tricuspid annulus. A second SVT consistent with a concealed nodoventricular pathway was successfully ablated at the right inferior extension of the AV nodal slow pathway. CONCLUSION We describe challenging cases of PJRT by virtue of complex anatomy, diagnostic features, and multiple arrhythmia mechanisms.
Collapse
Affiliation(s)
- Adam Oesterle
- Division of Cardiovascular Medicine, Department of Medicine, University of California Davis, Sacramento, California, USA
| | - Adam C Lee
- Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Aleksandr Voskoboinik
- Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Joshua D Moss
- Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Vasanth Vedantham
- Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Tomos E Walters
- Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Byron K Lee
- Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Zian H Tseng
- Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Edward P Gerstenfeld
- Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Melvin M Scheinman
- Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| |
Collapse
|
3
|
Ortman M, Ho RT. Reply to the Editor-Differentiation of atrioventricular nodal reentrant tachycardia and nodofascicular reentrant tachycardia. Heart Rhythm 2020; 17:2021-2022. [PMID: 32526350 DOI: 10.1016/j.hrthm.2020.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 06/03/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Matthew Ortman
- Division of Cardiology, Department of Medicine, Cooper Medical School of Rowan University, Camden, New Jersey.
| | - Reginald T Ho
- Division of Cardiology, Department of Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| |
Collapse
|
4
|
Letter to the Editor-Differentiation of atrioventricular nodal reentrant tachycardia and nodofascicular reentrant tachycardia. Heart Rhythm 2020; 17:2021. [PMID: 32526352 DOI: 10.1016/j.hrthm.2020.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 06/03/2020] [Indexed: 11/22/2022]
|
5
|
Kaiser DW, Rogers AJ, Narayan SM. Predictability in complex atrial arrhythmias: The N/N-1 algorithm to guide ablation of atrial tachycardias. Heart Rhythm 2019; 16:562-563. [PMID: 30465903 PMCID: PMC6467220 DOI: 10.1016/j.hrthm.2018.11.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Indexed: 11/27/2022]
Affiliation(s)
| | - Albert J Rogers
- Department of Medicine, Stanford University, Stanford, California
| | - Sanjiv M Narayan
- Department of Medicine, Stanford University, Stanford, California
| |
Collapse
|