Fusion of body surface potential and body surface Laplacian signals for electrocardiographic imaging

The surface Laplacian operator of the potentials on a bounded volume conductor has a unique inverse

In the discussion on the use of the surface Laplacian (SL) of the distribution of bioelectric potentials on the body surface, the question remained open whether a complete specification of the SL of the potential over the surface bounding a volume conductor would uniquely specify the potential on that surface up to a constant. This paper reports that this is indeed the case. In addition, it is shown that the integral of the SL over a closed surface is zero, a property that may serve as a check on the accuracy of any numerical approximation of the SL.

Body surface Laplacian mapping of atrial depolarization in healthy human subjects

In the present study, we report body surface Laplacian mapping of atrial depolarization under sinus rhythm in 8 healthy male subjects. For each subject, 95 unipolar disk electrodes with inter-electrode distance of 2 cm were used to record simultaneously potential ECGs over the anterior chest. The Laplacian ECG was then estimated during the P wave using a novel spline Laplacian technique. The body surface potential map (BSPM) and body surface Laplacian map (BSLM) at different time instants or time intervals of the P wave were constructed and compared. The present results showed that the BSPMs during the P wave were characterized by the rotation of a pair of positive/negative potential distribution from right to left around the anterior torso. On the other hand, the corresponding BSLMs revealed more spatial details, including two positive activities (denoted as P1 and P2, appeared in all 8 subjects), and three negative activities (denoted as N1, N2, and N3, appeared in 7, 7, and 4 subjects, respectively). The separation of these activities and their evolving patterns were also compared and confirmed by computer simulation using a realistic geometry heart-torso model. The above findings may be directly related to the underlying activation sequence during atrial depolarization in healthy subjects, suggesting the potential clinical applications of the Laplacian ECG technique.

A new method for incorporating weighted temporal and spatial smoothing in the inverse problem of electrocardiography

In this paper, we present a method for incorporating temporal smoothing (TS) into the estimate of epicardial potentials from body surface potential data. Our algorithm employs a different spatial smoothing parameter, chosen by the composite residual error and smoothing operator criteria, at each time step in the sequence. The total spatial smoothing term is then simply partitioned between temporal and spatial smoothing. The algorithm appears to be quite robust with regard to this partitioning. The new method was evaluated in the setting of additive Gaussian noise, but otherwise realistic conditions of body geometry and reference epicardial potentials. In examining the match between estimated and measured electrograms, or the match between estimated isopotential maps and measured isopotential maps, the estimates constructed using the new TS algorithm produced consistently smaller relative errors than those constructed using a quasi-static (QS) algorithm or those constructed by postprocessing the QS estimate with a moving average filter.

A spline Laplacian ECG estimator in a realistic geometry volume conductor

We have developed a spline-based Laplacian estimator over an arbitrarily shaped surface of a volume conductor and tested its applicability to Laplacian electrocardiogram (ECG) mapping. In the newly developed algorithm, estimation of the parameters associated with the spline Laplacian is formulated by seeking the general inverse of a transfer matrix. Only one spline-parameter needs to be determined through regularization in order to estimate the realistic geometry surface Laplacian from the body surface potentials. It has been demonstrated that the rich knowledge on regularization in the inverse problems can be directly applied to estimate the spline Laplacian ECG (LECG), such as the discrepancy principle. Computer simulations have been conducted to validate the new approach in a spherical volume conductor and test the feasibility of mapping cardiac electrical sources in a realistic geometry heart-torso model. The present results demonstrate that the realistic geometry spline LECG can be estimated conveniently from the body surface potentials, is more robust against measurement noise and has better performance than the conventional five-point local Laplacian estimator.