Visualizing current source density from intracardiac measurements

{ Grzegorz Parka, Piotr Podziemski, Jan Jacek ebrowski } Warsaw University of Technology, Faculty of Physics Results
entrant waves with limited number of electrodes placed in atria with commonly used intracardiac catheters. One of the potential techniques used for such visualization is the current source density mapping, which we test in our study. CSD reconstructions for 3 selected waves and 3 dierent electrode shapes.
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Background
The complexity of atrial arrhythmias makes the electrophysiological characterization of the reentrant processes dicult with conventional mapping techniques performed during electrophysiological study. The aim of our study was to evaluate new algorithms, that in future may enable to visualize re-

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a) raw current, b) measured potential,

c) interpolated potentials, d) estimated CSD (iCSD), e) estimated CSD (kCSD)

Methods
We performed a simulation of re-entrant electrical activation in a two-dimensional 5 cm x 5 cm tissue strip using a Fenton-Karma model of cardiac tissue, obtaining maps of transmembrane potential. Then, to model an intracardiac electrogram measurement, unipolar extracellular potentials were reconstructed for dierent conguration of electrode placement in the tissue strip. This includes electrodes such as grid, penta-array and lasso electrode. Two methods of Current Source Density estimation: Inverse Current Source Density (iCSD) [1] Kernel Current Source Density (kCSD) [2] were applied to reconstruct the electrical activation in the whole tissue strip using only the measurements from simulated unipolar electrodes. As a result, we obtained reconstructed current source density and potential for the whole strip, which was compared with underlying simulated transmembrane potential. This was repeated for
Figure 2: Lasso multielectrode catheter

dierent activation patterns, with a special focus on spiral waves.

We can see, that for a dense grid of electrodes, it is easy to recognize the region of activation and wave direction.
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Figure 1: Penta-array multielectrode catheter

x [mm] x [mm] x [mm] x [mm] x [mm] Reducing the number of electrodes brings signicant reduction of reconstruction quality. However for 22 electrodes, such as in penta-array it is still possible to reconstruct the shape and localize the probable origin of a reentrant wave using kCSD method. Methods such as iCSD can be also applied to interpolated potentials to estimate CSD but this requires an unnecessary step for interpolation and the error may be greater.
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Figure 3: Grid multielectrode

x [mm] x [mm] x [mm] x [mm] x [mm] Lasso catheter with 20 electrodes, bent into a spiral shape can also provide data for meaningful reconstructions of current source density in cardiac tissue.

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References
[1] Pettersen, K. H., Devor, A., Ulbert, I., Dale, A. M., Einevoll, G. T. (2006), Current-source density estimation based on inversion of electrostatic forward solution, J Neurosci Methods 154(1-2), 116-133 [2] J. Potworowski, W. Jakuczun, S. ski, D. K. Wjcik. Kernel Current Source Density Method. Neural Computation 24 (2012) 541-575.

Conclusions
Simulations show, that even for a limited number of electrodes, such as in case of penta-array or lasso catheters, it is possible to reconstruct proper direction and region of activation under the tissue area covered by electrodes. However, the reconstruction of the size of the activation and shape still needs to be improved for the method to be clinically useful.

Contact Information
Email parkag@ee.pw.edu.pl Phone 504 732 860