Limits...
Detailed Anatomical and Electrophysiological Models of Human Atria and Torso for the Simulation of Atrial Activation.

Ferrer A, Sebastián R, Sánchez-Quintana D, Rodríguez JF, Godoy EJ, Martínez L, Saiz J - PLoS ONE (2015)

Bottom Line: In recent years both P-waves and the BSPM have been used to identify the mechanisms underlying AF, such as localizing ectopic foci or high-frequency rotors.However, the relationship between the activation of the different areas of the atria and the characteristics of the BSPM and P-wave signals are still far from being completely understood.Using this multi scale model, it was revealed that the best places for recording P-waves are the frontal upper right and the frontal and rear left quadrants of the torso.

View Article: PubMed Central - PubMed

Affiliation: Centro de Investigación e Innovación en Bioingeniería (Ci2B), Universitat Politècnica de València, Valencia, Spain.

ABSTRACT
Atrial arrhythmias, and specifically atrial fibrillation (AF), induce rapid and irregular activation patterns that appear on the torso surface as abnormal P-waves in electrocardiograms and body surface potential maps (BSPM). In recent years both P-waves and the BSPM have been used to identify the mechanisms underlying AF, such as localizing ectopic foci or high-frequency rotors. However, the relationship between the activation of the different areas of the atria and the characteristics of the BSPM and P-wave signals are still far from being completely understood. In this work we developed a multi-scale framework, which combines a highly-detailed 3D atrial model and a torso model to study the relationship between atrial activation and surface signals in sinus rhythm. Using this multi scale model, it was revealed that the best places for recording P-waves are the frontal upper right and the frontal and rear left quadrants of the torso. Our results also suggest that only nine regions (of the twenty-one structures in which the atrial surface was divided) make a significant contribution to the BSPM and determine the main P-wave characteristics.

No MeSH data available.


Related in: MedlinePlus

Contribution to the ECG from individual atrial regions.a) Location of the maximum value of potential RMS produced from each atrial structure; b) B-RMS patterns (mVRMS) from the individual atrial structures with the highest contributions. Also displayed the P-waves (mV vs ms) registered at the point with maximum potential RMS value (red line) compared with the total P-wave registered at the same point (black line).
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4629897&req=5

pone.0141573.g010: Contribution to the ECG from individual atrial regions.a) Location of the maximum value of potential RMS produced from each atrial structure; b) B-RMS patterns (mVRMS) from the individual atrial structures with the highest contributions. Also displayed the P-waves (mV vs ms) registered at the point with maximum potential RMS value (red line) compared with the total P-wave registered at the same point (black line).

Mentions: As it was possible to isolate the contribution of each atrial region by masking the electrical contribution of other regions, we analysed the individual contribution to the B-RMS potential and corresponding P-wave produced by each atrial region in sinus rhythm. Fig 10a shows the torso surface area in which the different atrial regions present their maximum contribution to B-RMS maxima. Four spatial clusters can be identified: the G1 group (the lowest position of the frontal torso) with contributions from: RAA, RLW, TV, IB, PM, IST, RPV, LFO and ICV; the G2 group (the middle position) with contributions from: RAS, LAS, LSW, CT, BBL, SCV, BBR, MV; the G3 group (the upper position) with contributions from LAA, LPW and LPV; and the G4 group with contribution from regions with better registry on the back: LPW, LPV, RPV and CS. G1 shows the highest values produced by RAA and RLW, as confirmed from the amplitude of the individual P-wave (in red) related to the total P-wave (produced by the whole atrium) registered at the same point (in black). Should we consider the whole range of potential RMS and the B-RMS maps from each region, only 9 atrial structures/regions (RAA, RLW, TV, RAS, LAA, IB and LAS on the frontal view and LPW and LPV on the rear view), produce a significant potential contribution with very high (red) to medium (green) RMS values, as can be seen in Fig 10b. The other 12 atrial structures produce individual homogeneous body maps with RMS (blueish) values lower than 20% of the maximum contribution when considering the whole atria (S1 Fig shows the B-RMS produced by each of the 21 atrial regions). Fig 11a shows the potential RMS patterns obtained by adding the contribution of these 9 regions jointly, which are responsible for the 89% of the total contribution produced by the 21 regions (Fig 8). The other 12 structures, Fig 11b, are responsible for the remaining 11%, suggesting that the morphology of the total P-wave in sinus rhythm depends mainly on the 9 identified regions (even when they only represent the 65% of the total atrial volume).


Detailed Anatomical and Electrophysiological Models of Human Atria and Torso for the Simulation of Atrial Activation.

Ferrer A, Sebastián R, Sánchez-Quintana D, Rodríguez JF, Godoy EJ, Martínez L, Saiz J - PLoS ONE (2015)

Contribution to the ECG from individual atrial regions.a) Location of the maximum value of potential RMS produced from each atrial structure; b) B-RMS patterns (mVRMS) from the individual atrial structures with the highest contributions. Also displayed the P-waves (mV vs ms) registered at the point with maximum potential RMS value (red line) compared with the total P-wave registered at the same point (black line).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4629897&req=5

pone.0141573.g010: Contribution to the ECG from individual atrial regions.a) Location of the maximum value of potential RMS produced from each atrial structure; b) B-RMS patterns (mVRMS) from the individual atrial structures with the highest contributions. Also displayed the P-waves (mV vs ms) registered at the point with maximum potential RMS value (red line) compared with the total P-wave registered at the same point (black line).
Mentions: As it was possible to isolate the contribution of each atrial region by masking the electrical contribution of other regions, we analysed the individual contribution to the B-RMS potential and corresponding P-wave produced by each atrial region in sinus rhythm. Fig 10a shows the torso surface area in which the different atrial regions present their maximum contribution to B-RMS maxima. Four spatial clusters can be identified: the G1 group (the lowest position of the frontal torso) with contributions from: RAA, RLW, TV, IB, PM, IST, RPV, LFO and ICV; the G2 group (the middle position) with contributions from: RAS, LAS, LSW, CT, BBL, SCV, BBR, MV; the G3 group (the upper position) with contributions from LAA, LPW and LPV; and the G4 group with contribution from regions with better registry on the back: LPW, LPV, RPV and CS. G1 shows the highest values produced by RAA and RLW, as confirmed from the amplitude of the individual P-wave (in red) related to the total P-wave (produced by the whole atrium) registered at the same point (in black). Should we consider the whole range of potential RMS and the B-RMS maps from each region, only 9 atrial structures/regions (RAA, RLW, TV, RAS, LAA, IB and LAS on the frontal view and LPW and LPV on the rear view), produce a significant potential contribution with very high (red) to medium (green) RMS values, as can be seen in Fig 10b. The other 12 atrial structures produce individual homogeneous body maps with RMS (blueish) values lower than 20% of the maximum contribution when considering the whole atria (S1 Fig shows the B-RMS produced by each of the 21 atrial regions). Fig 11a shows the potential RMS patterns obtained by adding the contribution of these 9 regions jointly, which are responsible for the 89% of the total contribution produced by the 21 regions (Fig 8). The other 12 structures, Fig 11b, are responsible for the remaining 11%, suggesting that the morphology of the total P-wave in sinus rhythm depends mainly on the 9 identified regions (even when they only represent the 65% of the total atrial volume).

Bottom Line: In recent years both P-waves and the BSPM have been used to identify the mechanisms underlying AF, such as localizing ectopic foci or high-frequency rotors.However, the relationship between the activation of the different areas of the atria and the characteristics of the BSPM and P-wave signals are still far from being completely understood.Using this multi scale model, it was revealed that the best places for recording P-waves are the frontal upper right and the frontal and rear left quadrants of the torso.

View Article: PubMed Central - PubMed

Affiliation: Centro de Investigación e Innovación en Bioingeniería (Ci2B), Universitat Politècnica de València, Valencia, Spain.

ABSTRACT
Atrial arrhythmias, and specifically atrial fibrillation (AF), induce rapid and irregular activation patterns that appear on the torso surface as abnormal P-waves in electrocardiograms and body surface potential maps (BSPM). In recent years both P-waves and the BSPM have been used to identify the mechanisms underlying AF, such as localizing ectopic foci or high-frequency rotors. However, the relationship between the activation of the different areas of the atria and the characteristics of the BSPM and P-wave signals are still far from being completely understood. In this work we developed a multi-scale framework, which combines a highly-detailed 3D atrial model and a torso model to study the relationship between atrial activation and surface signals in sinus rhythm. Using this multi scale model, it was revealed that the best places for recording P-waves are the frontal upper right and the frontal and rear left quadrants of the torso. Our results also suggest that only nine regions (of the twenty-one structures in which the atrial surface was divided) make a significant contribution to the BSPM and determine the main P-wave characteristics.

No MeSH data available.


Related in: MedlinePlus