May 31, 2020Medical & Biological Engineering & ComputingOpen Access

In silico validation of electrocardiographic imaging to reconstruct the endocardial and epicardial repolarization pattern using the equivalent dipole layer source model

Q: What are the key findings of this study?

Electrocardiographic imaging using the equivalent dipole layer model accurately reconstructed cardiac repolarization times, demonstrating a strong overall correlation (R = 0.87) with the gold standard.

Q: What is the clinical evidence from this study?

Population: Healthy (In silico simulation) (n=1). Intervention: Equivalent dipole layer (EDL) model for electrocardiographic imaging vs. Anisotropic monodomain model simulated transmembrane potentials (gold standard). Primary outcome: Correlation between reconstructed and gold standard repolarization times (R 0.87, p=<0.01).

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Key result

Electrocardiographic imaging accurately reconstructs cardiac repolarization times with a strong ~0.87 correlation to the gold standard.

R 0.87
P<0.01
n=1

Why the study?

ECGI using the equivalent dipole layer model is accurate for cardiac activation times, but validation to determine repolarization times is lacking.

Does ECGI using the EDL model accurately reconstruct cardiac repolarization times compared to a gold standard in an in silico model?

Structured PICO

Does ECGI using the EDL model accurately reconstruct cardiac repolarization times compared to a gold standard in an in silico model?

Population

In silico model (monodomain model used to determine transmembrane potentials in three different excitation-repolarization patterns: sinus beat and ventricular ectopic beats)

Intervention

Electrocardiographic imaging (ECGI) using the equivalent dipole layer (EDL) model

Comparator

Gold standard (transmembrane potentials from the monodomain model)

Outcome

Accuracy of the EDL model in reconstructing cardiac repolarization timessurrogate

Main Result

Effect estimate: R 0.87

p-value: p=<0.01

ECGI using the EDL model accurately reconstructs cardiac repolarization times in silico, even with added noise and conductivity errors.

Limitations

Changes in geometry due to cardiac contraction, blood flow, and respiration were not taken into account
Parameterization of TMP for inverse calculation did not include the phase 1 dip
Different discretization between forward and inverse calculations (FEM versus BEM)
Potential model-to-model bias as geometry and electrode positions remained constant for both forward and inverse computations

Discussion

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Implication

Hypothesis-generating for EDL-based ECGI repolarization mapping; leaves open clinical translation pending in vivo validation.

Cite This Study

Waal et al. (2020) studied Healthy (In silico simulation) (n=1). Equivalent dipole layer (EDL) model for electrocardiographic imaging vs. Anisotropic monodomain model simulated transmembrane potentials (gold standard) was evaluated on Correlation between reconstructed and gold standard repolarization times (R 0.87, p=<0.01). Electrocardiographic imaging using the equivalent dipole layer model accurately reconstructed cardiac repolarization times, demonstrating a strong overall correlation (R = 0.87) with the gold standard.

synapsesocial.com/papers/6a0e9fc2b9cfc04f92479d88 https://doi.org/10.1007/s11517-020-02203-y

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In silico validation of electrocardiographic imaging to reconstruct the endocardial and epicardial repolarization pattern using the equivalent dipole layer source model

Structured PICO

Main Result

Limitations

Discussion

Implication

Cite This Study

In silico validation of electrocardiographic imaging to reconstruct the endocardial and epicardial repolarization pattern using the equivalent dipole layer source model

Structured PICO

Main Result

Limitations

Discussion

Implication

Cite This Study

Also Consider

Also Consider