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Force Trends and Pulsatility for Catheter Contact Identification in Intracardiac Electrograms during Arrhythmia Ablation

The intracardiac electrical activation maps are commonly used as a guide in the ablation of cardiac arrhythmias. The use of catheters with force sensors has been proposed in order to know if the electrode is in contact with the tissue during the registration of intracardiac electrograms (EGM). Altho...

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Autores principales: Rivas-Lalaleo, David, Muñoz-Romero, Sergio, Huerta, Mónica, Erazo-Rodas, Mayra, Sánchez-Muñoz, Juan José, Rojo-Álvarez, José Luis, García-Alberola, Arcadi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5981834/
https://www.ncbi.nlm.nih.gov/pubmed/29724033
http://dx.doi.org/10.3390/s18051399
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author Rivas-Lalaleo, David
Muñoz-Romero, Sergio
Huerta, Mónica
Erazo-Rodas, Mayra
Sánchez-Muñoz, Juan José
Rojo-Álvarez, José Luis
García-Alberola, Arcadi
author_facet Rivas-Lalaleo, David
Muñoz-Romero, Sergio
Huerta, Mónica
Erazo-Rodas, Mayra
Sánchez-Muñoz, Juan José
Rojo-Álvarez, José Luis
García-Alberola, Arcadi
author_sort Rivas-Lalaleo, David
collection PubMed
description The intracardiac electrical activation maps are commonly used as a guide in the ablation of cardiac arrhythmias. The use of catheters with force sensors has been proposed in order to know if the electrode is in contact with the tissue during the registration of intracardiac electrograms (EGM). Although threshold criteria on force signals are often used to determine the catheter contact, this may be a limited criterion due to the complexity of the heart dynamics and cardiac vorticity. The present paper is devoted to determining the criteria and force signal profiles that guarantee the contact of the electrode with the tissue. In this study, we analyzed 1391 force signals and their associated EGM recorded during 2 and 8 s, respectively, in 17 patients (82 ± 60 points per patient). We aimed to establish a contact pattern by first visually examining and classifying the signals, according to their likely-contact joint profile and following the suggestions from experts in the doubtful cases. First, we used Principal Component Analysis to scrutinize the force signal dynamics by analyzing the main eigen-directions, first globally and then grouped according to the certainty of their tissue-catheter contact. Second, we used two different linear classifiers (Fisher discriminant and support vector machines) to identify the most relevant components of the previous signal models. We obtained three main types of eigenvectors, namely, pulsatile relevant, non-pulsatile relevant, and irrelevant components. The classifiers reached a moderate to sufficient discrimination capacity (areas under the curve between 0.84 and 0.95 depending on the contact certainty and on the classifier), which allowed us to analyze the relevant properties in the force signals. We conclude that the catheter-tissue contact profiles in force recordings are complex and do not depend only on the signal intensity being above a threshold at a single time instant, but also on time pulsatility and trends. These findings pave the way towards a subsystem which can be included in current intracardiac navigation systems assisted by force contact sensors, and it can provide the clinician with an estimate of the reliability on the tissue-catheter contact in the point-by-point EGM acquisition procedure.
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spelling pubmed-59818342018-06-05 Force Trends and Pulsatility for Catheter Contact Identification in Intracardiac Electrograms during Arrhythmia Ablation Rivas-Lalaleo, David Muñoz-Romero, Sergio Huerta, Mónica Erazo-Rodas, Mayra Sánchez-Muñoz, Juan José Rojo-Álvarez, José Luis García-Alberola, Arcadi Sensors (Basel) Article The intracardiac electrical activation maps are commonly used as a guide in the ablation of cardiac arrhythmias. The use of catheters with force sensors has been proposed in order to know if the electrode is in contact with the tissue during the registration of intracardiac electrograms (EGM). Although threshold criteria on force signals are often used to determine the catheter contact, this may be a limited criterion due to the complexity of the heart dynamics and cardiac vorticity. The present paper is devoted to determining the criteria and force signal profiles that guarantee the contact of the electrode with the tissue. In this study, we analyzed 1391 force signals and their associated EGM recorded during 2 and 8 s, respectively, in 17 patients (82 ± 60 points per patient). We aimed to establish a contact pattern by first visually examining and classifying the signals, according to their likely-contact joint profile and following the suggestions from experts in the doubtful cases. First, we used Principal Component Analysis to scrutinize the force signal dynamics by analyzing the main eigen-directions, first globally and then grouped according to the certainty of their tissue-catheter contact. Second, we used two different linear classifiers (Fisher discriminant and support vector machines) to identify the most relevant components of the previous signal models. We obtained three main types of eigenvectors, namely, pulsatile relevant, non-pulsatile relevant, and irrelevant components. The classifiers reached a moderate to sufficient discrimination capacity (areas under the curve between 0.84 and 0.95 depending on the contact certainty and on the classifier), which allowed us to analyze the relevant properties in the force signals. We conclude that the catheter-tissue contact profiles in force recordings are complex and do not depend only on the signal intensity being above a threshold at a single time instant, but also on time pulsatility and trends. These findings pave the way towards a subsystem which can be included in current intracardiac navigation systems assisted by force contact sensors, and it can provide the clinician with an estimate of the reliability on the tissue-catheter contact in the point-by-point EGM acquisition procedure. MDPI 2018-05-02 /pmc/articles/PMC5981834/ /pubmed/29724033 http://dx.doi.org/10.3390/s18051399 Text en © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Rivas-Lalaleo, David
Muñoz-Romero, Sergio
Huerta, Mónica
Erazo-Rodas, Mayra
Sánchez-Muñoz, Juan José
Rojo-Álvarez, José Luis
García-Alberola, Arcadi
Force Trends and Pulsatility for Catheter Contact Identification in Intracardiac Electrograms during Arrhythmia Ablation
title Force Trends and Pulsatility for Catheter Contact Identification in Intracardiac Electrograms during Arrhythmia Ablation
title_full Force Trends and Pulsatility for Catheter Contact Identification in Intracardiac Electrograms during Arrhythmia Ablation
title_fullStr Force Trends and Pulsatility for Catheter Contact Identification in Intracardiac Electrograms during Arrhythmia Ablation
title_full_unstemmed Force Trends and Pulsatility for Catheter Contact Identification in Intracardiac Electrograms during Arrhythmia Ablation
title_short Force Trends and Pulsatility for Catheter Contact Identification in Intracardiac Electrograms during Arrhythmia Ablation
title_sort force trends and pulsatility for catheter contact identification in intracardiac electrograms during arrhythmia ablation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5981834/
https://www.ncbi.nlm.nih.gov/pubmed/29724033
http://dx.doi.org/10.3390/s18051399
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