Electric Imaging of Myocardial Ischemia
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CVRTI Electric Imaging of Myocardial Ischemia Rob MacLeod, Bonnie Punske, Shibaji Shome, Bulent Yilmaz, and Bruno Taccardi Cardiovascular Research and Training Institute Bioenginering Department University of Utah
description
Electric Imaging of Myocardial Ischemia. Rob MacLeod, Bonnie Punske, Shibaji Shome, Bulent Yilmaz, and Bruno Taccardi. Cardiovascular Research and Training Institute Bioenginering Department University of Utah. Origins. Occlusion. Pre-PTCA. Peak-PTCA. 0. mV. -80. - PowerPoint PPT Presentation
Transcript of Electric Imaging of Myocardial Ischemia
CVRTICVRTI
Electric Imaging of Myocardial Ischemia
Electric Imaging of Myocardial Ischemia
Rob MacLeod, Bonnie Punske,Shibaji Shome, Bulent Yilmaz, and
Bruno Taccardi
Cardiovascular Research and Training InstituteBioenginering Department
University of Utah
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OriginsOrigins
OcclusionPre-PTCA Peak-PTCA
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Biophysics of Acute IschemiaBiophysics of Acute Ischemia
0
-80
mV
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Imaging ApproachImaging Approach
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Cardiac Mapping of IschemiaCardiac Mapping of Ischemia
Source of Electrocardiographic ST Changes inSubendocardial Ischemia Li et al. Circ. Res. 82:957-970, 1998
Epicardium
Endocardium
LAD LCx
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Research QuestionsResearch Questions
• ST elevation or (transient) depression?• Acute occlusion versus graded flow?• How do ST changes image on the body
surface?
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Technical ApparatusTechnical Apparatus
• “Andy III”• 370 electrodes• R = 500 cm• Homogeneous• 1024 channel
acquisition
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Isolated Heart PreparationIsolated Heart Preparation
TorsoTank Electrodes
Epicardial Sock Electrodes
Support Dog
Flow Regulators
Heat ExchangeC J
ElectrolyticTorso Tank
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Flow ControlFlow ControlRoller PumpIsolated HeartLeft anterior descending artery
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Epicardial Electrode Sock Epicardial Electrode Sock
• Nylon stocking material
• 490 recording wires• 24 pacing wires• Reference markers
for geometry
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ProtocolsProtocols
• Acute, complete occlusion– 3-minute duration– measurements each 30 s
• Graded flow – 2-minute intervals at each flow rate– measurement at end of each interval
• Graded heart rate– constant flow rate– increase rate in 2-minute intervals– measurement at end of each interval
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Signal ProcessingSignal Processing
ToffQon Soff
3/8 5/8
SToff
80ms
ST80
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Tank/Heart GeometryTank/Heart Geometry
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Acute Occlusion
ST
Acute Occlusion
ST
300270240210180150120
906030
30
24
18
12
6
0ml/min s
Flow Time
4Jan01-ocl1
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Graded FlowST
Graded FlowST
30 ml/m
24 ml/m
18 ml/m
12 ml/m
6 ml/m
0 ml/m
10Jan01-ocl1
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Graded Pacing ST80
Graded Pacing ST80
34 ml/m
24 ml/m
18 ml/m
12 ml/m
6 ml/m
0 ml/m
215
190
165
150
130
Flow Heart Rate
10Jan01-ocl4
(reduced flow)
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Fixed Rate, Decreased FlowFixed Rate, Decreased Flow
• Start flow at 35• Reduce to 0• Increase back to 35• 3 minutes at each flow rate
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ReducedFlow:
ST-80
ReducedFlow:
ST-80
19Jan01-ocl1
35
28
21
14
7
0ml/min min
Flow Time
30272421181512
963
33
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ReducedFlow:
ST-80
ReducedFlow:
ST-80
19Jan01-ocl1
35
28
21
14
7
0ml/min min
Flow Time
30272421181512
963
33
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ReducedFlow:
ST-80
ReducedFlow:
ST-80
19Jan01-ocl1
35
28
21
14
7
0ml/min min
Flow Time
30272421181512
963
33
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ReducedFlow:
ST-80
ReducedFlow:
ST-80
19Jan01-ocl1
35
28
21
14
7
0ml/min min
Flow Time
30272421181512
963
33
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ReducedFlow:
ST-80
ReducedFlow:
ST-80
19Jan01-ocl1
35
28
21
14
7
0ml/min min
Flow Time
30272421181512
963
33
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ReducedFlow:
ST-80
ReducedFlow:
ST-80
19Jan01-ocl1
35
28
21
14
7
0ml/min min
Flow Time
30272421181512
963
33
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ReducedFlow:
ST-80
ReducedFlow:
ST-80
19Jan01-ocl1
35
28
21
14
7
0ml/min min
Flow Time
30272421181512
963
33
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ReducedFlow:
ST-80
ReducedFlow:
ST-80
19Jan01-ocl1
35
28
21
14
7
0ml/min min
Flow Time
30272421181512
963
33
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ReducedFlow:
ST-80
ReducedFlow:
ST-80
19Jan01-ocl1
35
28
21
14
7
0ml/min min
Flow Time
30272421181512
963
33
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ReducedFlow:
ST-80
ReducedFlow:
ST-80
19Jan01-ocl1
35
28
21
14
7
0ml/min min
Flow Time
30272421181512
963
33
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ReducedFlow:
ST-80
ReducedFlow:
ST-80
19Jan01-ocl1
35
28
21
14
7
0ml/min min
Flow Time
30272421181512
963
33
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ReducedFlow:
ST-80
ReducedFlow:
ST-80
19Jan01-ocl1
35
28
21
14
7
0ml/min min
Flow Time
30272421181512
963
33
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Fixed Flow, Increased RateFixed Flow, Increased Rate
• Start flow at 35• Reduce to 21• Increase rate
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Increased Rate:ST-80
Increased Rate:ST-80
19Jan01-ocl1
35
28
21
14
7
0ml/min min
Flow Time
200
188
176
167
158
214
231
BPM
Rate
18
15
12
9
6
3
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Increased Rate:ST-80
Increased Rate:ST-80
19Jan01-ocl1
35
28
21
14
7
0ml/min min
Flow Time
200
188
176
167
158
214
231
BPM
Rate
18
15
12
9
6
3
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Increased Rate:ST-80
Increased Rate:ST-80
19Jan01-ocl1
35
28
21
14
7
0ml/min min
Flow Time
200
188
176
167
158
214
231
BPM
Rate
18
15
12
9
6
3
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Increased Rate:ST-80
Increased Rate:ST-80
19Jan01-ocl1
35
28
21
14
7
0ml/min min
Flow Time
200
188
176
167
158
214
231
BPM
Rate
18
15
12
9
6
3
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Increased Rate:ST-80
Increased Rate:ST-80
19Jan01-ocl1
35
28
21
14
7
0ml/min min
Flow Time
200
188
176
167
158
214
231
BPM
Rate
18
15
12
9
6
3
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Increased Rate:ST-80
Increased Rate:ST-80
19Jan01-ocl1
35
28
21
14
7
0ml/min min
Flow Time
200
188
176
167
158
214
231
BPM
Rate
18
15
12
9
6
3
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Increased Rate:ST-80
Increased Rate:ST-80
19Jan01-ocl1
35
28
21
14
7
0ml/min min
Flow Time
200
188
176
167
158
214
231
BPM
Rate
18
15
12
9
6
3
