This U.S. patent application claims priority under 35 U.S.C. § 119 to: Indian Patent Application No. 202321080595, filed on Nov. 28, 2023. The entire contents of the aforementioned application are incorporated herein by reference.
The disclosure herein generally relates to the field of noninvasive estimation of atrial fibrillation source, and, more particularly, to a method and system for source localization of atrial fibrillation using probabilistic dominant frequency and spatiotemporal depolarization time.
Atrial fibrillation (AF) is a chronic arrhythmic disorder characterized by chaotic electrical activation of the atria, resulting in altered P wave, which is often absent and substituted by low amplitude and irregular atrial waves. This leads to inefficient blood pumping, increasing the risk of embolism, stroke, and cardiac failure. Clinical management of AF focuses on restoring sinus rhythm in the atria by pharmacological means or ablation of cardiac tissue responsible for arrhythmogenesis, but both approaches have suboptimal outcome in correcting AF. Location of arrhythmic sources are conventionally identified via an electrophysiological (EP) study, which is an invasive method, involving multiple catheters introduced in the atrial chambers to map the intracardiac signals. Local activation time (LAT) derived from signals captured by such catheters serve as a metric to identify arrhythmic sources. Such EP study is technically complex and expensive, demanding a large amount of time. Also, the complex atrial geometry and low spatial resolution of catheters limits proper electrical activity characterization of AF. Animal experiments and mapping studies have shown that chaotic and disorganized AF propagation are actually driven by rotors or focal drivers that are areas with high frequency depolarization. These drivers can originate anywhere in the atrium, mostly near scar or fibrosis cells.
ECGI (Electrocardiographic Imaging) is a recent approach towards non-invasive generation of cardiac activation maps for arrhythmic source localization that has gained immense research and medical interests. ECGI solves the inverse electrophysiology problem by reconstructing cardiac potential from torso or Body Surface Potential (BSP) using the 3D torso-cardiac structure segmented from Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) scans and some numerical methods and regularization algorithms. ECGI techniques and advanced signal processing involving atrial potential, dominant frequency and phase based analysis have been used in recent years to locate arrhythmia driving sources and improve ablation outcomes. However, characterization of electrical propagation in AF is difficult due to small volume and wall thickness of the atria, remodeling of the myocardium structure, errors due to ECGI regularization and functional collision of fibrillatory waves that creates high frequency values not associated with arrhythmic source. Some other prior arts use deep learning methods to detect source of AF from CT/MRI scans, but they require huge amount of training data to train neural networks.
Embodiments of the present disclosure present technological improvements as solutions to one or more of the above-mentioned technical problems recognized by the inventors in conventional systems. For example, in one embodiment, a method for source localization of atrial fibrillation is provided. The method includes obtaining a plurality of heart scan images and a plurality of torso scan images and extracting a) one or more atrial meshes from the plurality of heart scan images, and b) one or more torso meshes from the plurality of torso scan images. Further, the method includes sampling one or more Body Surface Potential (BSP) signals from the one or more torso meshes and the one or more atrial meshes and determining a cardiac potential from the one or more BSP signals. The method further includes identifying one or more probable rotor regions in the one or more atrial meshes based on the cardiac potential. Further, the method includes determining an Atrial Fibrillation-Dominant Frequency (AF-DF) probability based on the cardiac potential. Furthermore, the method includes determining a net probability of localizing AF source in the one or more atrial meshes by combining the identified one or more probable rotor regions and the AF-DF probability. The one or more atrial meshes having a net probability exceeding a threshold of net probability indicate locations of source of atrial fibrillation.
In another aspect, a system for source localization of atrial fibrillation is provided. The system includes a memory storing instructions; one or more communication interfaces; and one or more hardware processors coupled to the memory via the one or more communication interfaces, wherein the one or more hardware processors are configured by the instructions to: obtain a plurality of heart scan images and a plurality of torso scan images and extract a) one or more atrial meshes from the plurality of heart scan images, and b) one or more torso meshes from the plurality of torso scan images. Further, the one or more hardware processors are configured to sample one or more Body Surface Potential (BSP) signals from the one or more torso meshes and the one or more atrial meshes and determine a cardiac potential from the one or more BSP signals. The one or more hardware processors are further configured to identify one or more probable rotor regions in the one or more atrial meshes based on the cardiac potential. Further, the one or more hardware processors are configured to determine an Atrial Fibrillation-Dominant Frequency (AF-DF) probability based on the cardiac potential. Furthermore, the one or more hardware processors are configured to determine a net probability of localizing AF source in the one or more atrial meshes by combining the identified one or more probable rotor regions and the AF-DF probability. The one or more atrial meshes having a net probability exceeding a threshold of net probability indicate locations of source of atrial fibrillation.
In yet another aspect, there are provided one or more non-transitory machine-readable information storage mediums comprising one or more instructions which when executed by one or more hardware processors cause a method for source localization of atrial fibrillation. The method includes obtaining a plurality of heart scan images and a plurality of torso scan images and extracting a) one or more atrial meshes from the plurality of heart scan images, and b) one or more torso meshes from the plurality of torso scan images. Further, the method includes sampling one or more Body Surface Potential (BSP) signals from the one or more torso meshes and the one or more atrial meshes and determining a cardiac potential from the one or more BSP signals. The method further includes identifying one or more probable rotor regions in the one or more atrial meshes based on the cardiac potential. Further, the method includes determining an Atrial Fibrillation-Dominant Frequency (AF-DF) probability based on the cardiac potential. Furthermore, the method includes determining a net probability of localizing AF source in the one or more atrial meshes by combining the identified one or more probable rotor regions and the AF-DF probability. The one or more atrial meshes having a net probability exceeding a threshold of net probability indicate locations of source of atrial fibrillation.
It is to be understood that both the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of the invention, as claimed.
The accompanying drawings, which are incorporated in and constitute a part of this disclosure, illustrate exemplary embodiments and, together with the description, serve to explain the disclosed principles:
Exemplary embodiments are described with reference to the accompanying drawings. In the figures, the left-most digit(s) of a reference number identifies the figure in which the reference number first appears. Wherever convenient, the same reference numbers are used throughout the drawings to refer to the same or like parts. While examples and features of disclosed principles are described herein, modifications, adaptations, and other implementations are possible without departing from the scope of the disclosed embodiments.
Atrial fibrillation (AF) is a common cardiac arrhythmia with high prevalence and morbidity. AF can be managed by ablation therapy, where AF driving sources are identified and ablated to restore sinus rhythm. Conventionally, invasive techniques are used to localize AF sources, but they are inconvenient, technically complex, and expensive. Non-invasive methods such as ECGI are prone to errors due to small volume and wall thickness of the atria. In order to overcome the aforementioned technical challenges in state of the art techniques, embodiments of present disclosure provide a method and system for source localization of atrial fibrillation utilizing a modified dominant frequency approach and atrium depolarization time using spatiotemporal activation. The method initially obtains heart scan and torso scan images and extracts atrial meshes and torso meshes from them. Then, Body Surface Potential (BSP) signals are sampled from the atrial meshes and torso meshes. A cardiac potential is determined from the BSP signals from which AF-DF probability and probable rotor regions are computed. Finally, the probable AF sources are identified by combining both AF-DF probability and probable rotor regions.
Referring now to the drawings, and more particularly to
The I/O interface device(s) (106) can include a variety of software and hardware interfaces, for example, a web interface, a graphical user interface, and the like and can facilitate multiple communications within a wide variety of networks and protocol types, including wired networks, for example, LAN, cable, etc., and wireless networks, such as WLAN, cellular, or satellite. In an embodiment, the I/O interface device(s) (106) receives heart scan images and torso scan images and provides probable locations of source of Atrial Fibrillation as output. The memory (102) may include any computer-readable medium known in the art including, for example, volatile memory, such as static random access memory (SRAM) and dynamic random access memory (DRAM), and/or non-volatile memory, such as read only memory (ROM), erasable programmable ROM, flash memories, hard disks, optical disks, and magnetic tapes. The database 108 stores information pertaining to inputs fed to the system 100 and/or outputs generated by the system (e.g., at each stage), specific to the methodology described herein. Functions of the components of system 100 are explained in conjunction with flow diagram depicted in
In an embodiment, the system 100 comprises one or more data storage devices or the memory (102) operatively coupled to the processor(s) (104) and is configured to store instructions for execution of steps of the method (200) depicted in
Once the one or more BSP signals are pre-processed, at step 208 of the method 200, the one or more hardware processors 104 are configured to determine a cardiac potential (alternatively referred as atrial potential) from the one or more BSP signals using Inverse computed atrial EGM (icEGM) technique by solving the inverse problem of electrocardiography. icEGM is based on Maxwell's electromagnetic theory. According to Maxwell's electromagnetic wave equation, the potential measured at the torso surface (ϕT) is computed according to equation 1, where BTC is a transfer matrix (illustrated in
Once the cardiac potential is determined, at step 210 of the method 200, the one or more hardware processors 104 are configured to identify one or more probable rotor regions in the one or more atrial meshes based on the cardiac potential. The one or more probable rotor regions are identified based on a depolarization time (alternatively referred as activation time) which is computed from the cardiac potential. The depolarization time captures time course of an entire beat in single isochronal map. During AF, depolarization time increases due to increase in late component of the cardiac Na+ current (Ina, L) caused by increase in Na+ permeability. Sites showing late or increased depolarization during AF may be regarded as probable rotor regions (alternatively referred as rotor sites or rotor areas). Activation time at which the temporal behavior of depolarization occurs is computed from the cardiac potential ϕC by determining the most negative temporal derivative of each atrial node in the one or more atrial meshes. For complex surface like cardiac chambers, only temporal derivatives introduce errors, mostly when dealing with fractionated electrograms (EGM). It can be overcome by spatial computation of activation time, determined by implementing Laplacian of the cardiac potential, where the second order spatial derivative changes sign at the time of activation (depolarization). Combining both temporal and spatial derivatives, depolarization time is estimated from signals that have sharp changes in electric potential values in both time and space simultaneously. Computation of depolarization time can be mathematically represented by equation 3, wherein τ is the depolarization time, ∂ϕ(t)/∂t is the temporal derivative and Mϕ(t) is the spatial derivative. The resultant depolarization time is then smoothed by minimizing the function given in equation 4.
The first term in equation 4 is a least square minimization with respect to pre-smoothing estimation and the second term minimizes the surface Laplacian of the estimate. L is the Laplace operator. These two terms are balanced using parameter γ. For small value of γ, smoothing effect is low while for high value, resulting time estimate tends to zero. The smoothed depolarization time is then normalized. The one or more atrial meshes having normalized value of the computed depolarization time greater than a predefined threshold value are identified as the one or more probable rotor regions.
Further, at step 212 of the method 200, the one or more hardware processors 104 are configured to determine an Atrial Fibrillation-Dominant Frequency (AF-DF) probability based on the cardiac potential. Firstly, a Power Spectral Density (PSD) is estimated from the cardiac potential. Then, frequency values in the PSD are arranged in descending order. The peak or highest frequency value is considered as dominant frequency. To increase reliability of detecting peak power representing DF, a Regularity Index (RI) is computed as the ratio of the power at the DF and its adjacent frequencies (0.75-Hz band) to the power of the 3- to 15-Hz band. A high value of RI indicates high reliability, which means that the frequency peak under consideration makes a greater contribution to the selected frequency range. Then, the AF-DF probability is calculated as normalized value of ratio of power at a peak frequency and power at a second peak frequency in the PSD. The AF-DF probability metric further reduces errors in DF localization due to fibrillatory wave wandering, poor signal to noise ratio or errors due to geometric approximation.
Once the one or more probable rotor regions and AF-DF probability are determined, at step 214 of the method 200, the one or more hardware processors 104 are configured to determine a net probability of localizing AF source in the one or more atrial meshes by combining the identified one or more probable rotor regions and the AF-DF probability. The one or more atrial meshes having a net probability exceeding a threshold of net probability indicate locations of source of atrial fibrillation.
USE CASE EXAMPLE: The method 200 was performed on AF subject data from Experimental Data and Geometric Analysis Repository (EDGAR) database (contributed by Universität Politcnica de Valencia, Valencia, Spain). This dataset contains signals and geometrical meshes from 2 AF patients scheduled for an ablation procedure. BSP signals were recorded from 54 leads covering the torso. Ventricular activities were blocked by adenosine bolus infusion to record only the atrial contribution. Endocardial signals from 64 pole basket catheter located sequentially on the right and left atria were also recorded. The torso and atrial meshes extracted from patient MRI consisted of 2002 and 1998 nodes respectively. Sampling frequency for both BSP and endocardial signals were 2 kHz. 54 channel BSP signals were preprocessed as follows: 7.5 seconds long signals were segregated into 6 consecutive windows of 2 seconds each with 50% overlap. Electrical noise was removed using notch filter centered at 50 hz. Next, baseline wandering was removed by implementing multilevel 1D wavelet decomposition of level 10, using 6th order Daubechies wavelet filter. 10th level approximated signal was subtracted from the original signal, smoothed and low-pass filtered (15 Hz cut off) using a 6th-order Butterworth filter.
Experiments were performed on a simulated data set where ground truth rotor locations were known. This data set uses a realistic 3D atrial model to simulate atrial electrical activity, where activity of each node is modelled using ionic equations. For AF simulation, ionic currents and fibrosis distribution were varied to generate AF maintained by rotors that exhibits nonuniform propagation patterns. Atrial mesh consisted of 2048 nodes with 3 to 5 mm inter nodal distance. Simulated atrial EGM were processed at 500 Hz sampling frequency. AF episodes of 8 sec length were simulated by a single rotor located at left atrium at known node locations (around node number 1750 to 1950). Computed metrics were overlayed on 3D atrial geometry and visualized using Map3d software.
The written description describes the subject matter herein to enable any person skilled in the art to make and use the embodiments. The scope of the subject matter embodiments is defined by the claims and may include other modifications that occur to those skilled in the art. Such other modifications are intended to be within the scope of the claims if they have similar elements that do not differ from the literal language of the claims or if they include equivalent elements with insubstantial differences from the literal language of the claims.
It is to be understood that the scope of the protection is extended to such a program and in addition to a computer-readable means having a message therein; such computer-readable storage means contain program-code means for implementation of one or more steps of the method, when the program runs on a server or mobile device or any suitable programmable device. The hardware device can be any kind of device which can be programmed including e.g., any kind of computer like a server or a personal computer, or the like, or any combination thereof. The device may also include means which could be e.g., hardware means like e.g., an application-specific integrated circuit (ASIC), a field-programmable gate array (FPGA), or a combination of hardware and software means, e.g., an ASIC and an FPGA, or at least one microprocessor and at least one memory with software processing components located therein. Thus, the means can include both hardware means, and software means. The method embodiments described herein could be implemented in hardware and software. The device may also include software means. Alternatively, the embodiments may be implemented on different hardware devices, e.g., using a plurality of CPUs.
The embodiments herein can comprise hardware and software elements. The embodiments that are implemented in software include but are not limited to, firmware, resident software, microcode, etc. The functions performed by various components described herein may be implemented in other components or combinations of other components. For the purposes of this description, a computer-usable or computer readable medium can be any apparatus that can comprise, store, communicate, propagate, or transport the program for use by or in connection with the instruction execution system, apparatus, or device.
The illustrated steps are set out to explain the exemplary embodiments shown, and it should be anticipated that ongoing technological development will change the manner in which particular functions are performed. These examples are presented herein for purposes of illustration, and not limitation. Further, the boundaries of the functional building blocks have been arbitrarily defined herein for the convenience of the description. Alternative boundaries can be defined so long as the specified functions and relationships thereof are appropriately performed. Alternatives (including equivalents, extensions, variations, deviations, etc., of those described herein) will be apparent to persons skilled in the relevant art(s) based on the teachings contained herein. Such alternatives fall within the scope of the disclosed embodiments. Also, the words “comprising,” “having,” “containing,” and “including,” and other similar forms are intended to be equivalent in meaning and be open ended in that an item or items following any one of these words is not meant to be an exhaustive listing of such item or items or meant to be limited to only the listed item or items. It must also be noted that as used herein and in the appended claims, the singular forms “a,” “an,” and “the” include plural references unless the context clearly dictates otherwise.
Furthermore, one or more computer-readable storage media may be utilized in implementing embodiments consistent with the present disclosure. A computer-readable storage medium refers to any type of physical memory on which information or data readable by a processor may be stored. Thus, a computer-readable storage medium may store instructions for execution by one or more processors, including instructions for causing the processor(s) to perform steps or stages consistent with the embodiments described herein. The term “computer-readable medium” should be understood to include tangible items and exclude carrier waves and transient signals, i.e., be non-transitory. Examples include random access memory (RAM), read-only memory (ROM), volatile memory, nonvolatile memory, hard drives, CD ROMs, DVDs, flash drives, disks, and any other known physical storage media.
It is intended that the disclosure and examples be considered as exemplary only, with a true scope of disclosed embodiments being indicated by the following claims.
Number | Date | Country | Kind |
---|---|---|---|
202321080595 | Nov 2023 | IN | national |