Spatial refinement of a new algorithm to identify focus of atrial ectopic activity from 64-lead ECGs

Ectopic atrial activity, associated with atrial tachycardia and atrial fibrillation (AF), may predispose to cardiac arrhythmias, death and stroke. This abnormal activity may be reflected in changes to the P-wave morphology (PWM). Compared to the standard 12-lead ECG, more detailed ECG configurations may provide further information for locating the origin of atrial excitation without the need for invasive methods. In this study, we use a biophysically detailed model of the human atria and torso to develop and refine an algorithm for correlating the origin of atrial excitation with PWM. In simulation tests, the new algorithm had a success rate of 93%, which is higher than 72% of the one based on the 12-lead ECG.