A method for noninvasive beat-by-beat visualization of His bundle signals

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Noninvasive Electrocardiology Pub Date : 2023-07-26 DOI:10.1111/anec.13076

S. Sengottuvel ME, S. Shenbaga Devi PhD, M. Sasikala PhD, S. Satheesh DM, R. J. Selvaraj MD

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引用次数: 0

Abstract

Background

Invasive recording of His bundle signals (HBS) in electrophysiological study (EPS) is important in determining HV interval, the time taken to activate the ventricles from the His bundle. Noninvasive surface measurements of HBS are attempted by averaging typically 100–200 cardiac cycles of ECG time series in body surface potential mapping (BSPM) and in magnetocardiography (MCG) which records weak cardiac magnetic fields by highly sensitive detectors. However, noninvasive beat-by-beat extraction of HBS is challenged by ramp-like atrial signals and noise in PR segment of the cardiac cycle.

Methods

By making use of a signal-averaged trace showing prominent HBS as a guide trace, we developed a method combining interval-dependent wavelet thresholding (IDWT) and signal space projection (SSP) technique to eliminate artifacts from single beats. The method was applied on MCG recorded on 21 subjects with known HV intervals based on EPS and noninvasive signal-averaging, including five subjects with BSPM recorded subsequently. The method was also applied on stress-MCG of a subject featuring autonomic dynamics.

Results

HBS could be extracted from 19 out of 21 subjects by signal-averaging whose timing differed from EPS between −8 and 11 ms as tested by 2 observers. HBS in single beats were seen as aligned patterns in inter-beat contours and were appreciable in stress-MCG and conspicuous than BSPM. The performance of the method was evaluated on simulated and measured MCG to be adequate if the signal-to-noise ratio was at least 20 dB.

Conclusions

These results suggest the use of this method for noninvasive assessments on HBS.

Abstract Image

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一种无创的His束信号逐拍可视化方法

背景:在电生理研究(EPS)中，有创记录他束信号(HBS)对于确定HV间隔，即从他束激活心室所需的时间是很重要的。在体表电位映射(BSPM)和心脏磁图(MCG)中，通常通过平均100-200个心电周期时间序列来尝试对HBS进行无创表面测量，后者通过高灵敏度检测器记录弱心脏磁场。然而，无创逐拍HBS提取受到心周期PR段斜坡样心房信号和噪声的挑战。方法利用显示显著HBS的信号平均迹线作为引导迹线，我们开发了一种结合区间相关小波阈值(IDWT)和信号空间投影(SSP)技术的方法来消除单拍的伪影。将该方法应用于已知HV间隔的21例受试者的MCG记录，其中包括随后记录的5例BSPM受试者。该方法还应用于具有自主动力学特征的受试者的应力- mcg。结果经2名观察者测试，21名受试者中有19人可通过信号平均提取出HBS，其时间与EPS相差在- 8 ~ 11 ms之间。单拍下的HBS在拍间轮廓中呈排列模式，在应力- mcg中明显，比BSPM明显。在模拟和测量的MCG上，当信噪比至少为20 dB时，对该方法的性能进行了评估。结论该方法可用于HBS的无创评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Noninvasive Electrocardiology 医学-心血管系统

CiteScore

3.40

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： The ANNALS OF NONINVASIVE ELECTROCARDIOLOGY (A.N.E) is an online only journal that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients. ANE is the first journal in an evolving subspecialty that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients. The publication includes topics related to 12-lead, exercise and high-resolution electrocardiography, arrhythmias, ischemia, repolarization phenomena, heart rate variability, circadian rhythms, bioengineering technology, signal-averaged ECGs, T-wave alternans and automatic external defibrillation. ANE publishes peer-reviewed articles of interest to clinicians and researchers in the field of noninvasive electrocardiology. Original research, clinical studies, state-of-the-art reviews, case reports, technical notes, and letters to the editors will be published to meet future demands in this field.