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Minimally invasive recording of His bundle potentials using a gastro-thoracic electrode system configuration 微创记录他的束电位使用胃胸电极系统配置
Pub Date : 1996-12-15 DOI: 10.1109/CIC.1996.542574
Omar J. Escalona, David McEneaney, Jmcc Anderson
An important research initiative has allowed for the first time the basis of the Wellens protocol to be performed with a specially developed hexapolar gastro-oesophageal electrode (GOE) device. However, to maximize this new clinical procedure the addition of non-invasive His bundle potentials (HBP) detection will allow complete electro-physiological studies to be performed without the use of transvenous catheterisation and X-ray screening procedures. Thus, we have investigated a new method of HBP detection by using our GOE device. The novel lead configuration used here was between a high impedance chest electrode pad and the end tip electrode of the GOE device. This lead system configuration was combined with an optimized front-end ECG amplification and filtering, a high-resolution digitization at 16-bit, 4 kHz, and a particular SAECG processing technique. In a clinical trial, in four out of eight patients, successful detection of the HBP was observed. Detected HBP amplitude ranged between 1 and 3 /spl mu/V over a background noise (rms) ranging between 0.1 and 0.5 /spl mu/V as measured in the PR interval.
一项重要的研究计划首次允许使用专门开发的六极胃食管电极(GOE)装置来执行Wellens方案的基础。然而,为了最大限度地发挥这一新的临床程序的作用,增加了非侵入性的脑束电位(HBP)检测,可以在不使用经静脉导管和x射线筛查程序的情况下进行完整的电生理研究。因此,我们研究了一种利用我们的GOE装置检测HBP的新方法。这里使用的新型引线配置在高阻抗胸部电极垫和GOE设备的末端电极之间。该引线系统配置结合了优化的前端心电放大和滤波、16位、4 kHz的高分辨率数字化和特定的SAECG处理技术。在一项临床试验中,8名患者中有4名成功检测到HBP。在PR区间测量的背景噪声(rms)范围为0.1至0.5 /spl mu/V时,检测到的HBP振幅范围为1至3 /spl mu/V。
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引用次数: 0
ECG-gated ICUS image acquisition combined with a semi-automated contour detection provides accurate analysis of vessel dimensions 心电图门控ICUS图像采集与半自动轮廓检测相结合,提供了血管尺寸的准确分析
Pub Date : 1996-12-01 DOI: 10.1109/CIC.1996.542471
N. Bruining, C. Birgelen, M. Mallus, P. D. Feyter, E. Vrey, W. Li, Francesco Prati, P. W. Serruys, J. Roelandt
At present most systems used for three-dimensional (3D) reconstruction's of two-dimensional intracoronary ultrasound (ICUS) images are based on an image acquisition with a pull-back device which withdraws the catheter with a constant speed, not taking account of cardiac motion and coronary dynamics/pulsation. Cyclic changes of the vessel dimensions and the movement of the catheter inside the vessel result in artifacts and inaccuracies of quantitative analysis. Furthermore, most systems in use for this kind of analysis applications store the ICUS image data on video tape for off-line analysis, which results in quality loss. To overcome these limitations and to achieve a rapid on-line analysis without quality loss resulting from unnecessary A/D-conversions, ECG-gated acquisition and direct digitisation of ICUS images was performed on-line.
目前,用于二维冠状动脉内超声(ICUS)图像三维(3D)重建的大多数系统都是基于一个带拉回装置的图像采集,该装置以恒定的速度拔出导管,而不考虑心脏运动和冠状动脉动力学/脉动。血管尺寸的循环变化和导管在血管内的运动导致伪影和定量分析的不准确性。此外,用于这类分析应用程序的大多数系统将ICUS图像数据存储在录像带上用于离线分析,这导致质量损失。为了克服这些限制并实现快速在线分析,而不会因不必要的a / d转换而导致质量损失,在线进行了ecg门控采集和直接数字化ICUS图像。
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引用次数: 17
Use of object oriented relational databases for cardiac images 使用面向对象的关系数据库心脏图像
Pub Date : 1996-09-08 DOI: 10.1109/CIC.1996.542548
M. Baljon, M. Gerritsen
As the use of PACS in cardiac imaging is becoming more widespread, the demands on the functionality of PACS increases as well. OO database management software has become mature and use of it for PACS development can be considered as a possibility, especially the so called OO-relational DBMS solution that is capable of managing terabytes of information. The development of smart PACS for cardiac settings will become a realistic possibility. Experiences with one package are promising but much work has to be undertaken yet.
随着PACS在心脏成像中的应用越来越广泛,对PACS功能的要求也越来越高。面向对象数据库管理软件已经成熟,可以考虑将其用于PACS开发,特别是能够管理tb级信息的所谓面向对象关系DBMS解决方案。开发用于心脏设置的智能PACS将成为现实的可能性。一个包的经验很有希望,但还有很多工作要做。
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引用次数: 1
Numerical modeling of the failing ventricle: impact of a nonpulsatile ventricular assist system 衰竭心室的数值模拟:非搏动心室辅助系统的影响
Pub Date : 1996-09-08 DOI: 10.1109/CIC.1996.542499
Jianhua Zhou, A. Medvedev, W. Smith, L. Golding, J.D. Thomas
The Cleveland Clinic Implantable Ventricular Assist System (IVAS) is a nonpulsatile rotary pump designed to augment the failing left ventricle. The purpose of this study is to assess its impact on the cardiovascular system using computer simulation. The authors modified an existing numerical model (24 coupled differential equations representing all cardiac chambers and systemic and pulmonary vasculature). The pump was added as an auxiliary chamber between the left ventricle (LV) and aorta with pressure flow speed characteristics derived from in vitro testing. Pump function was assessed for normal and failing ventricles at various pump speeds. Computer simulations show that: 1) numerical modeling is useful for predicting hemodynamic response to IVAS; 2) IVAS results in normalization of cardiac output, especially in failing hearts, though with reduced pulse pressure.
克利夫兰诊所植入式心室辅助系统(IVAS)是一种非搏动式旋转泵,旨在增强衰竭的左心室。本研究的目的是利用计算机模拟评估其对心血管系统的影响。作者修改了现有的数值模型(24个耦合微分方程代表所有心室和全身和肺血管)。该泵作为左心室(LV)和主动脉之间的辅助腔室,具有体外测试得出的压力流量速度特性。在不同的泵速下评估正常心室和衰竭心室的泵功能。计算机模拟结果表明:1)数值模拟有助于预测IVAS的血流动力学响应;2) IVAS导致心输出量正常化,特别是在心力衰竭时,尽管脉压降低。
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引用次数: 0
Numerical studies of use-dependent block of cardiac sodium channels by quinidine on spiral wave reentry 奎尼丁在螺旋波再入时对心脏钠通道使用依赖性阻滞的数值研究
Pub Date : 1996-09-08 DOI: 10.1109/CIC.1996.542611
L. A. Irvine, R. Winslow
A numerical model of quinidine induced use-dependent blockade of cardiac sodium channels based on the modulated receptor hypothesis of Hille (1977) and Hondeghem and Katzung (1977) was developed. Model rate constants for transitions between non-drug bound and drug bound states were determined by fitting model responses to experimental data. The drug block model was incorporated into the Oxsoft HEART V4.2 single ventricular cell model, which in turn was used to construct two-dimensional ventricular cell networks. Spiral wave reentry was initiated in the two-dimensional networks and a step increase in quinidine concentration was applied uniformly to each cell. Core position was fixed in the absence of drug. In the presence of drug, core position underwent large spatial translations. As a result of these translations, individual cells exhibited action potentials with highly variable amplitude and interbeat interval.
基于Hille(1977)和Hondeghem and Katzung(1977)的调节受体假说,建立了奎尼丁诱导使用性心脏钠通道阻断的数值模型。通过拟合模型响应与实验数据来确定非药物结合状态和药物结合状态之间转变的模型速率常数。将药物阻滞模型纳入Oxsoft HEART V4.2单心室细胞模型,构建二维心室细胞网络。螺旋波在二维网络中重新进入,奎尼丁浓度均匀地逐步增加到每个细胞。在没有药物的情况下,固定核心位置。在药物作用下,核心位置发生了较大的空间平移。由于这些转换,单个细胞表现出高度可变振幅和间隔跳动的动作电位。
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引用次数: 8
Arterial pressure control during non-hypo/hypertensive changes in central venous volume: assessment with multivariate autoregressive modeling 中心静脉容积非低/高血压变化期间的动脉压控制:多变量自回归模型评估
Pub Date : 1996-09-08 DOI: 10.1109/CIC.1996.542479
R. Barbieri, J. Triedman, V. Di Virgilio, S. Cerutti, J. Saul
To evaluate how small decreases and increases of central volume influence heart rate and arterial pressure control multivariate autoregressive techniques were used to quantify the interactions between respiration, RR interval and arterial blood pressure during random interval breathing, at 3 low levels of lower body negative pressure and 3 low levels of increased central volume. In addition to the classic spectral parameters for each signal, the algorithms were used to derive the closed-loop feedforward and feedback gains for the baroreflex and the effects of respiration on RR interval. With reductions of central volume below control, baroreflex and respiratory sinus arrhythmia gains were generally reduced, while with increases of volume above control, they increased only for the first two levels, and decreased at the highest volume. These findings indicate that reflex heart rate control is maximum with mild hypervolemia, and are consistent with the presence of the Bainbridge reflex in healthy humans.
为了评估中央容积的小幅减少和增加如何影响心率和动脉压控制,我们使用多变量自回归技术来量化随机间歇呼吸期间,在3个低水平的下体负压和3个低水平的中央容积增加时,呼吸、RR间期和动脉血压之间的相互作用。除了每个信号的经典频谱参数外,该算法还用于导出气压反射的闭环前馈和反馈增益以及呼吸对RR间隔的影响。当中心容积低于控制时,压力反射和呼吸性窦性心律失常增益普遍降低,而当容积高于控制时,它们仅在前两个水平增加,在最高容积时下降。这些发现表明,反射性心率控制在轻度高血容量时达到最大,这与健康人群中班布里奇反射的存在是一致的。
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引用次数: 4
Optimal surface detection in intravascular ultrasound using multi-dimensional graph search 利用多维图搜索优化血管内超声表面检测
Pub Date : 1996-09-08 DOI: 10.1109/CIC.1996.542469
R. Frank, D. McPherson, K. Chandran, E. Dove
A new algorithm is proposed for the detection of optimal surfaces in multi-dimensional datasets. The algorithm is based on multi-dimensional dynamic programming. Cost functions were derived using a cylindrical object model by resampling the raw image data along perpendiculars to a prior contour. Radial and angular smoothing filters were used together with a radial derivative operator to convert the data into a cost function. The algorithm was applied To IVUS image sequences of explanted peripheral arterial segments. The algorithm was assessed by comparing the arterial wall estimates obtained from tracings, obtained slice by slice, by an expert human. The slope and intercept were: 1.06/spl plusmn/0.05, -57/spl plusmn/255 pixels, respectively. The slope and intercepts were not different from unity and zero, respectively (p>0.2). The algorithm is capable of recovering surfaces in 3D, has fixed memory requirements, and is fast.
提出了一种新的多维数据集最优曲面检测算法。该算法基于多维动态规划。通过对原始图像数据沿垂直于先验轮廓线的重新采样,利用圆柱形对象模型推导了代价函数。径向和角度平滑滤波器与径向导数算子一起将数据转换为代价函数。将该算法应用于外植外周动脉段IVUS图像序列。通过比较由专家逐片获得的跟踪获得的动脉壁估计值来评估该算法。斜率和截距分别为:1.06/spl plusmn/0.05, -57/spl plusmn/255像素。斜率和截距分别与1和0无差异(p>0.2)。该算法具有三维曲面恢复能力强、内存要求固定、速度快等优点。
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引用次数: 15
A pacing parameter for controlling ventricular rate during atrial fibrillation: potential correlation to hemodynamic function 房颤期间控制室率的起搏参数:与血流动力学功能的潜在相关性
Pub Date : 1996-09-08 DOI: 10.1109/CIC.1996.542544
S. Greenhut, B. Steinhaus, J. Fraser, W. Hughes
The irregular ventricular (V) rate of atrial fibrillation (AF) may contribute to adverse hemodynamics and symptoms. An algorithm that adjusts pacing rate based on RR interval mean absolute difference (MADIFF) to reduce AF V rate variability was tested. Previous algorithms used a fixed % of V pacing to change pacing rate. Patients with chronic AF, intact AV nodal conduction, and a pacemaker were studied during V rate stabilization (VRS) pacing and control. Previous work showed that cardiac output was inversely related to the % of RRs which were short relative to the preceding RR. VRS eliminated 74% and 81% of cycles more than 10% and 20% shorter than the preceding RR interval. MADIFF was better correlated to the % of cycles more than 10% and 20% less than the preceding RR than was % pacing. Hence, a MADIFF-based VRS algorithm reduced the % of short RRs and may be a better indicator/controller of hemodynamic performance in AF than % pacing.
心房颤动(AF)的不规则心室(V)率可能导致不良的血流动力学和症状。测试了一种基于RR间隔平均绝对差(MADIFF)调整起搏速率的算法,以降低AF - V率的变异性。以前的算法使用固定%的V起搏来改变起搏速率。慢性房颤患者,完整的房室结传导和起搏器在V率稳定(VRS)起搏和控制期间进行了研究。先前的研究表明,心输出量与相对于前RR短的RR百分比呈负相关。VRS消除了74%和81%的周期比之前的RR间隔短10%和20%。与%起搏率相比,MADIFF与循环率大于10%和小于前RR 20%的相关性更好。因此,基于maff的VRS算法降低了短rr的百分比,可能是比%起搏更好的房颤血流动力学性能指标/控制器。
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引用次数: 0
Repolarization alternans detection using the KL transform and the beatquency spectrum 利用KL变换和频率谱进行复极化交替检测
Pub Date : 1996-09-08 DOI: 10.1109/CIC.1996.542626
P. Laguna, M. Ruiz, G. Moody, R. Mark
Electrical alternans at the repolarization phase of the cardiac cycle have been reported to be related with increased risk for ventricular arrhythmias (VA). Here, the authors present and study a method for detecting ST-T complex alternans based on the Karhunen-Loeve (KL) transform and a beatquency transform (Fourier transform of KL series with beat order as temporal reference). The ratio of the power in the band around 0.5 cycles/beat with respect to the total power is then used as indicator of the period 2 alternans presence. This is similarly done for period 4 alternans. To study the performance of this detection system the authors have generated a simulated alternating ECG with added noise (moving artifacts, EMG and baseline wander noise). The results for SNR around 15 dB for the ST-T complex (normal value for ECG signals) give a sensitivity and specificity for period 2 alternans detection of over 95%. This method applied to the entire European ST-T database gives 25 alternating episodes, 56% corresponding to ischemic episodes, showing that 5.3% of the ischemic episodes include alternans episodes.
据报道,在心脏周期的复极化阶段的电交替与室性心律失常(VA)的风险增加有关。在这里,作者提出并研究了一种基于Karhunen-Loeve (KL)变换和频率变换(KL序列的傅立叶变换以拍阶为时间参考)的ST-T复交替检测方法。在0.5个周期/拍的波段内的功率相对于总功率的比率,然后被用作周期2交替存在的指标。第四周期交替也是如此。为了研究该检测系统的性能,作者生成了一个添加噪声(运动伪影、肌电图和基线漂移噪声)的模拟交变心电。ST-T复合体(ECG信号的正常值)的信噪比约为15 dB,对第2周期交替检测的灵敏度和特异性超过95%。该方法应用于整个欧洲ST-T数据库,得到25次交替发作,56%对应于缺血发作,表明5.3%的缺血发作包括交替发作。
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引用次数: 35
Deformable model application on segmentation in 3-D echocardiography 可变形模型在三维超声心动图分割中的应用
Pub Date : 1996-09-08 DOI: 10.1109/CIC.1996.542561
P. Linares, V. Torrealba, G. Montilla, A. Bosnjak, C. Jimenez, V. Barrios
This work presents 3D cardiac images rendering based on volumetrics of plane sections obtained from the cardiac wall segmentation. This work introduces a non-rigid model based on physics as a segmentation method. An object is constructed in the shape of a polygon of n vertices, with masses on each of them, interconnected with springs to each other. The model is deformed when exposed to a force field that moves it toward the desired contour. In order to obtain the volumetric reconstructed rendering of the ventricular cavity, the method was used on a series of apical views of the heart of a healthy person. The views belong to radial sections (equally spaced in angle) which, alter segmentation, and by means of a bilinear interpolation process, permitted the reconstruction of a 3D image of the ventricular cavity.
这项工作提出了三维心脏图像的绘制基于从心壁分割得到的平面切片的体积。本文介绍了一种基于物理的非刚性模型作为分割方法。一个物体被构造成一个有n个顶点的多边形,每个顶点上都有质量,彼此之间用弹簧相互连接。当暴露在使模型向所需轮廓移动的力场中时,模型就会变形。为了获得心室腔的体积重建渲染,将该方法应用于健康人心脏的一系列顶点视图。视图属于径向部分(角度等间距),改变分割,并通过双线性插值过程,允许重建心室腔的三维图像。
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引用次数: 8
期刊
Computers in Cardiology 1996
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