Post on 01-Jan-2016
Imaging Electrical ActivitImaging Electrical Activityy of the Heartof the Heart
Özlem Özmen OkurÖzlem Özmen Okur
BM573 CARDIOVASCULAR IMAGINGBM573 CARDIOVASCULAR IMAGING
Student PresentationStudent Presentation
28.11.200528.11.2005 Imaging Electrical Activity of the HeartImaging Electrical Activity of the Heart 22/21/21
Contraction of a Cardiac Muscle CellContraction of a Cardiac Muscle Cell
In the heart:In the heart:Iionic current triggers the rhythmic muscle contractions that pump blood in and out. Iionic current triggers the rhythmic muscle contractions that pump blood in and out.
http://butler.cc.tut.fi/~malmivuo/bem/bembook/06/06.htm http://butler.cc.tut.fi/~malmivuo/bem/bembook/06/06.htm
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The The DDifferent ifferent WWaveforms for aveforms for EEach of ach of the the SSpecialized pecialized CCells ells
http://butler.cc.tut.fi/~malmivuo/bem/bembook/06/06x/conducti/0607i.htm http://butler.cc.tut.fi/~malmivuo/bem/bembook/06/06x/conducti/0607i.htm
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Need for Mapping of Electrical Need for Mapping of Electrical ActivityActivity
To understand the mechanisms responsible for the normal cardiac rhythm To understand the mechanisms responsible for the normal cardiac rhythm and for the initation and maintenance of arrhythmias.and for the initation and maintenance of arrhythmias.
http://www.comsol.com/stories/heart/http://www.comsol.com/stories/heart/http://butler.cc.tut.fi/~malmivuo/bem/bembook/06/06x/isochron/65.htm http://butler.cc.tut.fi/~malmivuo/bem/bembook/06/06x/isochron/65.htm
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Problems (1)Problems (1) Normal Sinus Rhythm (: All Normal Sinus Rhythm (: All
complexes normal, evenly complexes normal, evenly spacedspacedRate 60 - 100/min Rate 60 - 100/min
Sinus Bradycardia: All Sinus Bradycardia: All complexes normal, evenly complexes normal, evenly spacedspacedRate < 60 - 100/minRate < 60 - 100/min
Sinus Tachycardia: All Sinus Tachycardia: All complexes normal, evenly complexes normal, evenly spacedspacedRate > 100/min Rate > 100/min
Sinus Arrythmia: All Sinus Arrythmia: All complexes normal, rhythm is complexes normal, rhythm is irregularirregular
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Problems (2)Problems (2) WANDERING WANDERING
PACEMAKERPACEMAKER (Impulses (Impulses originate from varying points originate from varying points in atria): Variation in P-wave in atria): Variation in P-wave contour, P-R and P-P interval contour, P-R and P-P interval and therefore in R-R intervals and therefore in R-R intervals
ATRIAL FLUTTER ATRIAL FLUTTER (Impulses travel in circular (Impulses travel in circular course in atriacourse in atria)): Rapid : Rapid flutter waves, ventricular flutter waves, ventricular response irregularresponse irregular
ATRIAL FIBRILLATION ATRIAL FIBRILLATION (Impulses have chaotic, (Impulses have chaotic, random pathways in atria): random pathways in atria): Baseline irregular, Baseline irregular, ventricular response ventricular response irregularirregular
VENTRICULAR VENTRICULAR FIBRILLATIONFIBRILLATIONChaotic ventricular Chaotic ventricular depolarizationdepolarization
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Wave pattern (a single spiral) on the ventricular Wave pattern (a single spiral) on the ventricular surface, during monomorphic tachycardia surface, during monomorphic tachycardia
http://www.math.utah.edu/~keener/lectures/maw/slide8.html http://www.math.utah.edu/~keener/lectures/maw/slide8.html
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Surface View of FibrillationSurface View of Fibrillation
http://www.math.utah.edu/~keener/lectures/maw/slide13.html http://www.math.utah.edu/~keener/lectures/maw/slide13.html
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Imaging Electrical Activity of the HeartImaging Electrical Activity of the Heart
Reconstruction from internally located Reconstruction from internally located electrodeselectrodes
Electrocardiographic ImagingElectrocardiographic Imaging Optical ImagingOptical Imaging Magnetocardiographic ImagingMagnetocardiographic Imaging
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Ventricular Ventricular JJacket acket AArrayrray
VahlhausVahlhaus, Christian, et al; “, Christian, et al; “Direct epicardial mapping predicts the recovery of left ventricular dysfunction in chronic ischaemic Direct epicardial mapping predicts the recovery of left ventricular dysfunction in chronic ischaemic myocardiummyocardium”; European Heart Journal; v. 25; n. 2; pp. 151-157; 2003.”; European Heart Journal; v. 25; n. 2; pp. 151-157; 2003.
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IInternally nternally LLocated ocated DDefibrillation efibrillation EElectrodeslectrodes
LeftLeft: : anterioranterior, r, rightight: : posterior view of the posterior view of the heart and the major heart and the major vessels of the heart. vessels of the heart.
RedRed: : regions of large regions of large current densitiescurrent densities
BBluelue: : regions of regions of relatively lower current relatively lower current densities.densities.
http://www.http://www.liblib..utahutah.edu/.edu/gouldgould/2000/lecture00.html/2000/lecture00.html
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Electrocardiographic ImagingElectrocardiographic Imaging
NoninvasiveNoninvasive Using body surface Using body surface
measurementsmeasurements RReconstructeconstructionion on the on the
heart's surface using heart's surface using geometrical information geometrical information from computed from computed tomography (CT) and a tomography (CT) and a mathematical algorithm. mathematical algorithm.
Burnes, John, et al; "A Noninvasive Imaging Modality for Cardiac Burnes, John, et al; "A Noninvasive Imaging Modality for Cardiac Arrhythmias"; Nature Medicine; n. 10; pp. 422-428; 2004.Arrhythmias"; Nature Medicine; n. 10; pp. 422-428; 2004.
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Optical Imaging of Electrical Optical Imaging of Electrical Activity in the HeartActivity in the Heart
Cardiac action potentials are recorded using Cardiac action potentials are recorded using voltage-sensitive dyes to monitor voltage-sensitive dyes to monitor
cellular potential, cellular potential, cell to cell interactions, and cell to cell interactions, and propagation and repolarization "patterns" propagation and repolarization "patterns"
underlying cardiac arrhythmias. underlying cardiac arrhythmias.
http://www.http://www.metrohealthresearchmetrohealthresearch.org/.org/hvrcresearchelectrophyshvrcresearchelectrophys.html.html
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Optical Properties of Membrane-Bound Dyes That Have Been Used to Measure
Membrane Potential Changes
Fluorescence, Absorption, Dichroism, Birefringence, Fluorescence resonance energy transfer, Nonlinear second harmonic generation, and Resonance Raman absorption.
considerably less sensitive to movement artifacts generated by muscle contractions
Efimov, Igor, et al; "Optical Imaging of the Heart"; Circ. Res.; n.95; pp. 21-33; 2004.Efimov, Igor, et al; "Optical Imaging of the Heart"; Circ. Res.; n.95; pp. 21-33; 2004.
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Schematics of a Typical Optical Schematics of a Typical Optical Mapping SystemMapping System
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Mapping of Activation and Repolarization
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Magnetocardiographic ImagingMagnetocardiographic Imaging
http://www.hitachi.com/ICSFiles/afieldfile/2004/06/08/r2001_01_103.pdfhttp://www.hitachi.com/ICSFiles/afieldfile/2004/06/08/r2001_01_103.pdf
MMagnetocardiographs taken from the front and back of the heartagnetocardiographs taken from the front and back of the heart ..UUsing a special magnetic sensor called SQUIDsing a special magnetic sensor called SQUID (8100 fT to severeal tens of pT is emitted from the (8100 fT to severeal tens of pT is emitted from the heart)heart) WWhile clothed.hile clothed.
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Ischemic Heart Disease ExampleIschemic Heart Disease Example
http://www.hitachi.com/ICSFiles/afieldfile/2004/06/08/r2001_01_103.pdfhttp://www.hitachi.com/ICSFiles/afieldfile/2004/06/08/r2001_01_103.pdf
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MMagnetocardiographagnetocardiographicic 3-D 3-D VVisualization of isualization of HHeart eart CCurrent urrent DDistributionistribution
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ReferencesReferences
Burnes, John, et al; "A Noninvasive Imaging Modality for Cardiac Burnes, John, et al; "A Noninvasive Imaging Modality for Cardiac Arrhythmias"; Nature Medicine; n. 10; pp. 422-428; 2004.Arrhythmias"; Nature Medicine; n. 10; pp. 422-428; 2004.
Vahlhaus, Christian, et al; “Direct epicardial mapping predicts the Vahlhaus, Christian, et al; “Direct epicardial mapping predicts the recovery of left ventricular dysfunction in chronic ischaemic recovery of left ventricular dysfunction in chronic ischaemic myocardium”; European Heart Journal; v. 25; n. 2; pp. 151-157; 2003.myocardium”; European Heart Journal; v. 25; n. 2; pp. 151-157; 2003.
Efimov, Igor, et al; "Optical Imaging of the Heart"; Circ. Res.; n.95; pp. Efimov, Igor, et al; "Optical Imaging of the Heart"; Circ. Res.; n.95; pp. 21-33; 2004.21-33; 2004.
http://butler.cc.tut.fi/~malmivuo/bem/bembook/06/http://butler.cc.tut.fi/~malmivuo/bem/bembook/06/ http://www.comsol.com/stories/heart/http://www.comsol.com/stories/heart/ http://www.math.utah.edu/~keener/lectures/maw/http://www.math.utah.edu/~keener/lectures/maw/ http://www.lib.utah.edu/gould/2000/lecture00.htmlhttp://www.lib.utah.edu/gould/2000/lecture00.html http://www.nature.com/nm/journal/v10/n4/abs/nm1011.html http://www.nature.com/nm/journal/v10/n4/abs/nm1011.html http://www.metrohealthresearch.org/hvrcresearchelectrophys.htmlhttp://www.metrohealthresearch.org/hvrcresearchelectrophys.html http://www.hitachi.com/ICSFiles/afieldfile/2004/06/08/r2001_01_103.pdf http://www.hitachi.com/ICSFiles/afieldfile/2004/06/08/r2001_01_103.pdf
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