Spatiotemporal approximation of cardiac activation and recovery isochrones.

Background: The sequence of myocardial activation and recovery can be studied in detail by invasive catheter recordings of cardiac electrograms (EGMs), or noninvasive inverse reconstructions thereof with electrocardiographic imaging (ECGI). Local activation and recovery times are obtained from a unipolar EGM by the moment of maximum downslope of the QRS complex or maximum upslope of the T wave, respectively. However, both invasive and noninvasive recordings of intracardiac EGMs may suffer from noise and fractionation, making reliable detection of these deflections nontrivial.

Novel Metric Using Laplacian Eigenmaps to Evaluate Ischemic Stress on the Torso Surface.

The underlying pathophysiology of myocardial ischemia is incompletely understood, resulting in persistent difficulty of diagnosis. This limited understanding of underlying mechanisms encourages a data driven approach, which seeks to identify patterns in the ECG data that can be linked statistically to disease states. Laplacian Eigen-maps (LE) is a dimensionality reduction method popularized in machine learning that we have shown in large animal experiments to identify underlying ischemic stress both earlier in an ischemic episode, and more robustly, than typical clinical markers.

Temporal Performance of Laplacian Eigenmaps and 3D Conduction Velocity in Detecting Ischemic Stress.

Background: Myocardial ischemia has a complex and time-varying electrocardiographic signature that is used to diagnose and stratify severity. Despite the ubiquitous clinical use of the ECG to detect ischemia, the sensitivity and specificity of ECG based detection of myocardial ischemia are still inadequate.

Purpose: The purpose of this study was to compare, using animal models, the performance of several traditional ECG-based metrics for detecting acute ischemia against two novel metrics, the Laplacian Eigenmap (LE) parameters and a three-dimensional estimate of Conduction Velocity (CV).

Detecting Ischemic Stress to the Myocardium Using Laplacian Eigenmaps and Changes to Conduction Velocity.

The underlying pathophysiology of ischemia and its electrocardiographic consequences are poorly understood, resulting in unreliable diagnosis of this disease. This limited knowledge of underlying mechanisms suggests a data driven approach, which seeks to identify patterns in the ECG that can be linked statistically to underlying behavior and conditions of ischemic stress. The gold standard ECG metrics for evaluating ischemia monitor vertical deflections within the ST segment.

A Potential-Based Inverse Spectral Method to Noninvasively Localize Discordant Distributions of Alternans on the Heart From the ECG.

Unlabelled: T-wave alternans (TWA), defined as the beat-to-beat alternation in amplitude of the T-waves, has been shown to be linked to ventricular fibrillation (VF). However, current TWA tests have high sensitivity but low specificity in determining who is at risk. To overcome this limitation, it might be helpful to determine the spatial distribution of any regions on the heart that alternate in opposite phase.

Optimizing Stimulus Patterns for Dense Array tDCS With Fewer Sources Than Electrodes Using A branch and Bound Algorithm.

Dense array transcranial direct current stimulation (tDCS) has become of increasing interest as a noninvasive modality to modulate brain function. To target a particular brain region of interest (ROI), using a dense electrode array placed on the scalp, the current injection pattern can be appropriately optimized. Previous optimization methods have assumed availability of individually controlled current sources for each non-reference electrode.

Novel Biomarker for Evaluating Ischemic Stress Using an Electrogram Derived Phase Space.

The underlying pathophysiology of ischemia is poorly understood, resulting in unreliable clinical diagnosis of this disease. This limited knowledge of underlying mechanisms suggested a data driven approach, which seeks to identify patterns in the ECG data that can be linked statistically to underlying behavior and conditions of ischemic tissue. Previous studies have suggested that an approach known as Laplacian eigenmaps (LE) can identify trajectories, or manifolds, that are sensitive to different spatiotemporal consequences of ischemic stress, and thus serve as potential clinically relevant biomarkers.

Motion-Robust Diffusion-Weighted Brain MRI Reconstruction Through Slice-Level Registration-Based Motion Tracking.

This work proposes a novel approach for motion-robust diffusion-weighted (DW) brain MRI reconstruction through tracking temporal head motion using slice-to-volume registration. The slice-level motion is estimated through a filtering approach that allows tracking the head motion during the scan and correcting for out-of-plane inconsistency in the acquired images. Diffusion-sensitized image slices are registered to a base volume sequentially over time in the acquisition order where an outlier-robust Kalman filter, coupled with slice-to-volume registration, estimates head motion parameters.

Evaluation of motion and its effect on brain magnetic resonance image quality in children.

Background: Motion artifacts pose significant problems for the acquisition of MR images in pediatric populations.

Objective: To evaluate temporal motion metrics in MRI scanners and their effect on image quality in pediatric populations in neuroimaging studies.

Materials And Methods: We report results from a large pediatric brain imaging study that shows the effect of motion on MRI quality.

Dynamic Electrical Source Imaging (DESI) of Seizures and Interictal Epileptic Discharges Without Ensemble Averaging.

We propose an algorithm for electrical source imaging of epileptic discharges that takes a data-driven approach to regularizing the dynamics of solutions. The method is based on linear system identification on short time segments, combined with a classical inverse solution approach. Whereas ensemble averaging of segments or epochs discards inter-segment variations by averaging across them, our approach explicitly models them.

Extensions to a manifold learning framework for time-series analysis on dynamic manifolds in bioelectric signals.

This paper addresses the challenge of extracting meaningful information from measured bioelectric signals generated by complex, large scale physiological systems such as the brain or the heart. We focus on a combination of the well-known Laplacian eigenmaps machine learning approach with dynamical systems ideas to analyze emergent dynamic behaviors. The method reconstructs the abstract dynamical system phase-space geometry of the embedded measurements and tracks changes in physiological conditions or activities through changes in that geometry.

Optimization of focality and direction in dense electrode array transcranial direct current stimulation (tDCS).

Objective: Transcranial direct current stimulation (tDCS) aims to alter brain function non-invasively via electrodes placed on the scalp. Conventional tDCS uses two relatively large patch electrodes to deliver electrical current to the brain region of interest (ROI). Recent studies have shown that using dense arrays containing up to 512 smaller electrodes may increase the precision of targeting ROIs.

New Additions to the Toolkit for Forward/Inverse Problems in Electrocardiography within the SCIRun Problem Solving Environment.

Cardiac electrical imaging often requires the examination of different forward and inverse problem formulations based on mathematical and numerical approximations of the underlying source and the intervening volume conductor that can generate the associated voltages on the surface of the body. If the goal is to recover the source on the heart from body surface potentials, the solution strategy must include numerical techniques that can incorporate appropriate constraints and recover useful solutions, even though the problem is badly posed. Creating complete software solutions to such problems is a daunting undertaking.

Identifying model inaccuracies and solution uncertainties in noninvasive activation-based imaging of cardiac excitation using convex relaxation.

Noninvasive imaging of cardiac electrical function has begun to move towards clinical adoption. Here, we consider one common formulation of the problem, in which the goal is to estimate the spatial distribution of electrical activation times during a cardiac cycle. We address the challenge of understanding the robustness and uncertainty of solutions to this formulation.

Using transmural regularization and dynamic modeling for noninvasive cardiac potential imaging of endocardial pacing with imprecise thoracic geometry.

Cardiac electrical imaging from body surface potential measurements is increasingly being seen as a technology with the potential for use in the clinic, for example for pre-procedure planning or during-treatment guidance for ventricular arrhythmia ablation procedures. However several important impediments to widespread adoption of this technology remain to be effectively overcome. Here we address two of these impediments: the difficulty of reconstructing electric potentials on the inner (endocardial) as well as outer (epicardial) surfaces of the ventricles, and the need for full anatomical imaging of the subject's thorax to build an accurate subject-specific geometry.

Uncertainty Visualization in Forward and Inverse Cardiac Models.

Quantification and visualization of uncertainty in cardiac forward and inverse problems with complex geometries is subject to various challenges. Specific to visualization is the observation that occlusion and clutter obscure important regions of interest, making visual assessment difficult. In order to overcome these limitations in uncertainty visualization, we have developed and implemented a collection of novel approaches.

Spatiotemporal estimation of activation times of fractionated ECGs on complex heart surfaces.

Identification of electrical activation or depolarization times on sparsely-sampled complex heart surfaces is of importance to clinicians and researchers in cardiac electrophysiology. We introduce a spatiotemporal approach for activation time estimation which combines prior results using spatial and temporal methods with our own progress on gradient estimation on triangulated surfaces. Results of the method applied to simulated and canine heart data suggest that improvements are possible using this novel combined approach.

Analysis of the criteria of activation-based inverse electrocardiography using convex optimization.

In inverse electrocardiography (ECG), the problem of finding activation times on the heart noninvasively from body surface potentials is typically formulated as a nonlinear least squares optimization problem. Current solutions rely on iterative algorithms which are sensitive to the presence of local minima. As a result, improved initialization approaches for this problem have been of considerable interest.

A toolkit for forward/inverse problems in electrocardiography within the SCIRun problem solving environment.

Computational modeling in electrocardiography often requires the examination of cardiac forward and inverse problems in order to non-invasively analyze physiological events that are otherwise inaccessible or unethical to explore. The study of these models can be performed in the open-source SCIRun problem solving environment developed at the Center for Integrative Biomedical Computing (CIBC). A new toolkit within SCIRun provides researchers with essential frameworks for constructing and manipulating electrocardiographic forward and inverse models in a highly efficient and interactive way.

DIFFERENTIAL GEOMETRIC APPROXIMATION OF THE GRADIENT AND HESSIAN ON A TRIANGULATED MANIFOLD.

In a number of medical imaging modalities, including measurements or estimates of electrical activity on cortical or cardiac surfaces, it is often useful to estimate spatial derivatives of data on curved anatomical surfaces represented by triangulated meshes. Assuming the triangle vertices are points on a smooth manifold, we derive a method for estimating gradients and Hessians on locally 2D surfaces embedded in 3D directly in the global coordinate system. Accuracy of the method is validated through simulations on both smooth and corrugated surfaces.