Inverse localization of earliest cardiac activation sites from activation maps based on the viscous Eikonal equation

GEASI: Geodesic-based earliest activation sites identification in cardiac models

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, for example, 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.

An Inverse Problem Involving a Viscous Eikonal Equation with Applications in Electrophysiology

In this work we discuss the reconstruction of cardiac activation instants based on a viscous Eikonal equation from boundary observations. The problem is formulated as a least squares problem and solved by a projected version of the Levenberg-Marquardt method. Moreover, we analyze the well-posedness of the state equation and derive the gradient of the least squares functional with respect to the activation instants. In the numerical examples we also conduct an experiment in which the location of the activation sites and the activation instants are reconstructed jointly based on an adapted version of the shape gradient method from (J. Math. Biol. 79, 2033-2068, 2019). We are able to reconstruct the activation instants as well as the locations of the activations with high accuracy relative to the noise level.