Abstract:

ECG imaging is an emerging technology for the reconstruction of cardiac electric activity from non-invasively measured body surface potential maps. In this case report, we present the first evaluation of transmurally imaged activation times against endocardially reconstructed isochrones for a case of sustained monomorphic ventricular tachycardia (VT). Computer models of the thorax and whole heart were produced from MR images. A recently published approach was applied to facilitate electrode localization in the catheter laboratory, which allows for the acquisition of body surface potential maps while performing non-contact mapping for the reconstruction of local activation times. ECG imaging was then realized using Tikhonov regularization with spatio-temporal smoothing as proposed by Huiskamp and Greensite and further with the spline-based approach by Erem et al. Activation times were computed from transmurally reconstructed transmembrane voltages. The results showed good qualitative agreement between the non-invasively and invasively reconstructed activation times. Also, low amplitudes in the imaged transmembrane voltages were found to correlate with volumes of scar and grey zone in delayed gadolinium enhancement cardiac MR. The study underlines the ability of ECG imaging to produce activation times of ventricular electric activity-and to represent effects of scar tissue in the imaged transmembrane voltages.

Abstract:

ntercellular heterogeneity is fundamental to most biological tissues. For some cell types, heterogeneity is thought to be responsible for distinct cellular phenotypes and functional roles. In the pancreatic islet, subsets of phenotypically distinct beta cells (hub and leader cells) are thought to coordinate electrical activity of the beta cell network. This hypothesis has been addressed by experimental and computational approaches, but none have attempted to reconstruct functional specialization directly from measured heterogeneity. To evaluate if electrophysiologic heterogeneity alone can explain these specialized functional roles, we created a population of human beta cell models (via genetic algorithm optimization) recapitulating the heterogeneity in an extensive patch clamp dataset (1021 pancreatic cells). Then we applied the simplified Kirchhoff network (SKNM) formalism to simulate activity of that population in a connected beta cell network. We could not immediately observe cells with obvious hub or leader phenotypes within the heterogeneous network. However, with this study we built the basis for further ''ground-up'' investigation of relationships between beta cell heterogeneity and human islet function. Moreover, our workflow may be translated to other tissues where large electrophysiologic data sets become available, and heterogeneity is thought to influence tissue function e.g. human atria.