Search PubMed⌕ Search

Biomedical subjects

B B Punske

Publications and source records attributed to B B Punske.

9 recordsLinked to original sources
PubMed2000

Computing and visualizing electric potentials and current pathways in the thorax.

The long-term goal of electrocardiography is to relate electric potentials on the body surface with activities in the heart. Many previously reported studies have focused on direct links between heart and body surface potentials. The goals of this study were first to validate computational methods of determining volume potentials and currents with high-resolution experimental measurements and then to use interactive visualization of thoracic currents to understand features of the electrocardiographic fields from measured cardiac sources. We developed both simulation and experimental studies based on a realistic shaped torso phantom containing an isolated, perfused dog heart. Interventions included atrial pacing, single pacing and simultaneously pacing at multiple locations on the ventricles. Simulated torso volume potentials closely matched measured potentials in the torso-tank preparation (mean correlation coefficients of 0.95). Simulation further provided a means of estimating the current field in the torso from the computed torso volume potentials and the local geometric and conductive properties of the medium. Applying these techniques to the torso electric fields under a variety of pacing conditions, we have further demonstrated that thoracic current can provide many insights into the relationship between heart surface potential and body surface potentials. Specifically, we have shown that geometric factors including cardiac source configuration and location play an important role in determining to what extent electric activity in the heart is directly visible on the body surface electrocardiogram. The computation and visualization toolkit we developed in this study to explore current fields associated with cardiac events may provide new insights into electrocardiology.

Action Potentials↗
PubMed1999

Assessment of spatial resolution of pace mapping when using body surface potentials.

Using computer simulations and statistical methods, the resolution of pace mapping when used in combination with body surface potentials was systematically investigated. In an anatomical model of the human ventricular myocardium, pre-excitation sequences were initiated at 69 sites positioned along the atrioventricular (AV) ring and corresponding body surface potential maps (BSPMs) were calculated at 32 leads placed on the anterior torso. For each time after the onset of pre-excitation (every 4 ms to 40 ms) and each root-mean-square (RMS) noise level (5, 10, 20 and 50 microV), BSPMs were cros-correlated and the spatial resolution defined as the largest pacing site separation at which the differences in correlation coefficients were not statistically significant (level p > or = 0.05). The findings indicate that when random RMS noise of 5 microV was added to the simulated BSPMs, average spatial resolution over all 60 sites was at 20 ms after the onset of pre-excitation within 3.5 +/- 0.9 mm. The results provide theoretical evidence that statistical analysis of BSPMs obtained during pace mapping can offer improved means for subcentimetre identification of accessory pathways located along the AV ring.

Body Surface Potential Mapping↗
PubMed1999

Noninvasive indices of repolarization and its dispersion.

In experimental studies using Langendorff perfused, isolated canine hearts immersed in a torso-shaped electrolytic tank we studied repolarization and its dispersion using direct epicardial measurements and newly derived, noninvasive body surface indices. Activation recovery intervals (ARIs) measured from 64 epicardial sites based on differences between activation times (ATs) and recovery times (RTs) provided direct measures of repolarization. The indirect, torso surface indices were derived from inflections of the root-mean-square (RMS) voltage of the torso tank surface electrocardiograms recorded simultaneously with the epicardial data. For cycle lengths ranging from 300 to 900 ms, and electrolyte temperatures ranging from 32 degrees C to 40 degrees C we calculated mean, variance, and range of ATs, RTs, and ARIs from the epicardium. From epicardial and torso surface RMS waveforms, we used times of R and T peaks and their differences to estimate mean ATs, RTs, and ARIs, respectively. The RMS T wave width as determined from the second derivative inflections on either side of the T peak served as an estimate of the dispersion of RTs. In parallel studies, we showed that the direct measures of repolarization and its dispersion were reflected in RMS waveforms generated from the epicardial electrograms themselves. In this study, we confirm that the torso and epicardial RMS waveforms reflect comparable information for estimating repolarization and its dispersion. Furthermore, the derived measures provide a method to assess mean ARIs and dispersion of RTs on a beat-to-beat basis and during abnormal (ectopic ventricular) activation sequences.

Animals↗
PubMed1999

Mechanisms of the spatial distribution of QT intervals on the epicardial and body surfaces.

INTRODUCTION: The role of QT dispersion as a predictor of arrhythmia vulnerability has not been consistently confirmed in the literature. Therefore, it is important to identify the electrophysiologic mechanisms that affect QT duration and distribution. We compared the spatial distributions of QT intervals (QTI) with potential distributions on cardiac and body surfaces and with recovery times on the cardiac surface. We hypothesized that the measure of QTI is affected by the presence of the zero potential line in the potential distribution, as well as the sequence of recovery. We also investigated use of the STT area as a possible indicator of recovery times on the cardiac surface. METHODS AND RESULTS: High-resolution spatial distributions of QTI and potentials were determined on the body surface of human subjects and on the surface of a torso-shaped tank containing an isolated canine heart. Additionally, spatial distributions of QTI, recovery times, and STT areas were determined on the surface of exposed canine hearts. Unipolar electrograms were recorded during atrial and ventricular pacing for normal hearts and cases of myocardial infarction. Regions of shortest QTI always coincided with the location of the zero potential line on the cardiac and body surfaces. On the cardiac surface, in regions away from the zero line, similarities were observed between the patterns of QTI and the sequence of recovery. STT areas and recovery times were highly correlated on the cardiac surface. CONCLUSION: QTI is not a robust index of local recovery time on the cardiac surface. QTI distributions were affected by the position of the zero potential line, which is unrelated to local recovery times. However, similarities in the patterns of QTI and recovery times in some regions may help explain the frequently reported predictive value of QT dispersion. Preliminary results indicate STT area may be a better index of recovery time and recovery time dispersion on the epicardium than QTI.

Animals↗
PubMed1998

A comparison of simulated QRS isointegral maps resulting from pacing at adjacent sites: implications for the spatial resolution of pace mapping using body surface potentials.

The precise localization of ventricular tachycardia (VT) foci is a prerequisite for the successful radiofrequency catheter ablation in patients. The purpose of this study was to systematically quantify over what distance adjacent sites in the right ventricular (RV) and left ventricular (LV) epicardium and LV endocardium could be distinguished by inspecting morphological features of QRS isointegral maps using statistical methods. We investigated the spatial resolution of QRS isointegral maps by means of an anatomically accurate computer model of the human ventricular myocardium that incorporates a bidomain model for simulating the realistic activation sequences and the oblique dipole model in combination with the boundary element method for calculating extracardiac potentials. In this model, we initiated activation sequences at a total of 183 epicardial and 75 LV endocardial pacing sites, positioned in three levels (basal, middle, and apical). For each of the 258 pacing sites, we calculated a set of 10 QRS isointegral maps with added Gaussian noise at 117 leads (covering the anterior and posterior torso) and at 32 leads (covering only the anterior torso), respectively. Sets of maps were then cross correlated and root-mean-square (RMS) values of difference maps were calculated for all possible pairs of pacing sites on the same level. We applied the nonparametric unpaired Kolmogorov-Smirnov test and defined the spatial resolution as the pacing site separation at which the differences in correlation coefficients and RMS differences were significant (level P < .05). We observed significant differences in maps when the distances between pacing sites were on average (+/- SD) greater than 4.3 +/- 1.0 mm. In more than 90% of pacing sites, the significant differences in maps were observed within 4 mm even when using a 32-lead mapping system. The findings of our study provide theoretical evidence that QRS isointegral maps may offer noninvasive means for preinterventional planning of the ablative treatment in localizing both endocardial and epicardial sites of origin of VT.

Body Surface Potential Mapping↗
PubMed1998

Useful lessons from body surface mapping.

Useful Lessons from Body Surface Mapping. Body surface potential maps (BSMs) depict the time varying distribution of cardiac potentials on the entire surface of the torso. Hundreds of studies have shown that BSMs contain more diagnostic and prognostic information than can be elicited from the 12-lead ECG. Despite these advantages, body surface mapping has not become a routinely used clinical method. One reason is that visual examination and sophisticated analysis of BSMs do not permit inferring the sequence of excitation and repolarization in the heart with a sufficient degree of certainty and detail. These limitations can be partially overcome by implementing inverse procedures that reconstruct epicardial potentials, isochrones, and ECGs from body surface measurements. Furthermore, ongoing experimental work and simulation studies show that a great deal of information about intramural events can be elicited from measured or reconstructed epicardial potential distributions. Interpreting epicardial data in terms of deep activity requires extensive knowledge of the architecture of myocardial fibers, their anisotropic properties, and the role of rotational anisotropy in affecting propagation and the associated potential fields.

Body Surface Potential Mapping↗
PubMedDate not supplied

Quantitative characterization of epicardial wave fronts during regional ischemia and elevated extracellular potassium ion concentration.

This study applied zero-delay wave number spectral estimation as a means of quantifying the changes in activation and recovery sequences of propagating plane waves on the epicardial surface of in situ porcine hearts during regional hyperkalemia and ischemia. Unipolar electrograms (104) were recorded from the left ventricular surface of nine hearts using a plaque electrode array with 1 mm spatial sampling intervals. The objectives were (1) to define a set of parameters capable of quantifying the spatial and temporal changes in measured extracellular potentials associated with localized ischemia prior to the onset of conduction block; (2) to elevate regional levels of extracellular potassium ion concentration and quantify potential changes due to this known physiologic manipulation; and (3) to use quantitative parameters to make statistical comparisons in order to distinguish wave fronts during normal, ischemic and hyperkalemic conditions. Results showed that the parameters of wave number and average temporal frequency and the associated power, as determined from the wave number spectrum, provided statistically significant (p<0.05) quantification of changes in wave front features during normal and ischemic or hyperkalemic conditions. The results were consistent with results obtained from conventional time-space domain methods like isochronal mapping and electrograms, with the advantage of a quantitative result enabling simple comparisons and trend analysis for large numbers of heart beats.

Animals↗