Three-dimensional ventricular activation imaging by means of equivalent current source modeling and estimation

This paper presents a novel electrocardiographic inverse approach for imaging the 3-D ventricular activation sequence based on the modeling and estimation of the equivalent current density throughout the entire myocardial volume. The spatio-temporal coherence of the ventricular excitation process is utilized to derive the activation time from the estimated time course of the equivalent current density. At each time instant during the period of ventricular activation, the distributed equivalent current density is noninvasively estimated from body surface potential maps (BSPM) using a weighted minimum norm approach with a spatio-temporal regularlzatlon strategy based on the singular value decomposition of the BSPMs. The activation time at any given location within the ventricular myocardium is determined as the time point with the maximum local current density estimate. Computer simulation has been performed to evaluate the capability of this approach to image the 3-D ventricular activation sequence initiated from a single pacing site in a physiologically realistic cellular automaton heart model. The simulation results demonstrate that the simulated "true" activation sequence can be accurately reconstructed with an average correlation coefficient of 0.90, relative error of 0.19, and the origin of ventricular excitation can be localized with an average localization error of 5.5 mm for 12 different pacing sites distributed throughout the ventricles.