The personalization of cardiac models is the cornerstone of patient-specific modeling. Ideally, non-invasive or minimally-invasive clinical data, such as the standard ECG or intracardiac contact recordings, could provide an insight on modelparameters. Parameter selection of such models is however a challenging and potentially time-consuming task. In this work, we estimate the earliest activation sites governing the cardiac electrical activation. Specifically, we introduce GEASI (Geodesic-based Earliest Activation Sites Identification) as a novel approach to simultaneously identify their locations and times . To this end, we start from the anisotropic eikonal equation modeling cardiac electrical activation and exploit its Hamilton-Jacobi formulation to minimize a given objective functional, which in the case of GEASI is the quadratic mismatch to given activation measurements. This versatile approach can be extended for computing topological gradients to estimate the number of sites , or fitting a given ECG. We conducted various experiments in 2D and 3D for in-silico models and an in-vivo intracardiac recording collected from a patient undergoing cardiac resynchronization therapy. The results demonstrate the clinical applicability of GEASI for potential future personalized models and clinical intervention.
The identification of the initial ventricular activation sequence is a critical step for the correct personalization of patient-specific cardiac models. In healthy conditions, the Purkinje network is the main source of the electrical activation, but under pathological conditions the so-called earliest activation sites (EASs) are possibly sparser and more localized. Yet, their number, location and timing may not be easily inferred from remote recordings, such as the epicardial activation or the 12-lead electrocardiogram (ECG), due to the underlying complexity of the model. In this work, we introduce GEASI (Geodesic-based Earliest Activation Sites Identification) as a novel approach to simultaneously identify all EASs . To this end, we start from the anisotropic eikonal equation modeling cardiac electrical activation and exploit its Hamilton--Jacobi formulation to minimize a given objective function, e.g. the quadratic mismatch to given activation measurements. This versatile approach can be extended to estimate the number of activation sites by means of the topological gradient , or fitting a given ECG. We conducted various experiments in 2D and 3D for in-silico models and an in-vivo intracardiac recording collected from a patient undergoing cardiac resynchronization therapy. The results demonstrate the clinical applicability of GEASI for potential future personalized models and clinical intervention.
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personalization of cardiac models is the cornerstone of patient-specific modeling. Ideally, non-invasive or minimally-invasive clinical data,
identification of the initial ventricular activation sequence is a critical step for the correct personalization of patient-specific cardiac models. In healthy conditions, the Purkinje network is the main source of the electrical activation, but under pathological conditions the so-called earliest activation sites (EASs) are possibly sparser and more localized. Yet, their number, location and timing may not be easily inferred from remote recordings,
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standard ECG or intracardiac contact recordings, could provide an insight on modelparameters. Parameter selection of such models is however a challenging and potentially time-consuming task.
epicardial activation or the 12-lead electrocardiogram (ECG), due to the underlying complexity of the model.
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estimate the earliest activation sites governing the cardiac electrical activation. Specifically, we
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their locations and times
all EASs
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Hamilton-Jacobi
Hamilton--Jacobi
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functional, which in the case of GEASI is the
function, e.g. the
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for computing topological gradients
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sites
activation sites by means of the topological gradient