Venous catheter based mapping of epicardial ectopic activation

Catheter based electrophysiological studies of the epicardium are limited to regions near the coronary vessels or require transthoracic access. We have developed a statistical approach by which to estimate high-resolution maps of epicardial activation from very low-resolution multielectrode venous catheter measurements. Essential components of this approach are the training data set composition and the catheter electrode locations used to determine the relationship between catheter sites and the remaining measurement sites on the epicardium. We report here on the methods we investigated to show the effect of the content of the training set. Our results showed that the closer the match between features of the maps to be reconstructed and the training data set. the more estimation accurately predicted the earliest site of activation. We also report results from two different approaches to leadset selection by which we obtained similar accuracy levels. The results of this study suggest that reconstructing complete epicardial activation maps from venous catheter based measurements is both feasible and practical for future clinical applications.