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P Le Guyader

Publications and source records attributed to P Le Guyader.

3 recordsLinked to original sources

Extracellular measurement of anisotropic bidomain myocardial conductivities. I. Theoretical analysis.

The passive electrical properties of cardiac tissue, such as the intracellular and interstitial conductivities along the longitudinal and transverse axes, have not been often measured because intracellular electrodes are usually needed for these measurements. In this paper, we present a theoretical analysis of two myocardial models developed to estimate these properties by analyzing potentials recorded with a pair of extracellular electrodes while injecting alternating current between another pair of electrodes. First, the cardiac tissue is represented by a standard bidomain model which includes a membrane capacitance; second, this model is modified by adding an intracellular capacitance representing the intercalated disks. Numerical solutions are computed with a fast Fourier transform algorithm without constraining the anisotropy ratios of the interstitial and intracellular domains. We systematically investigate the effects of changes in the bidomain parameters on the voltage-to-current ratio curves. We also demonstrate how the bidomain parameters can be theoretically estimated by fitting, with a modified Shor's r algorithm, the simulated potentials along the longitudinal and transverse axes for different frequencies between 10 and 10,000 Hz. An important finding is that the interelectrode distance must be similar to the myocardial space constant so as to obtain frequency dependent measurements.

Algorithms↗

Discrimination between monomorphic and polymorphic ventricular tachycardia using cycle length variability measured by wavelet transform analysis.

The objective of this study was to assess the capability of wavelet transform (WT) analysis to differentiate between monomorphic (MVTs) and polymorphic ventricular tachycardias (PVTs) in a canine model and to relate these results to epicardial isochronal maps on a beat-by-beat basis. Unipolar electrograms were simultaneously recorded from the surface of both ventricles with a 127-lead sock electrode array in 24 open-chest anesthetized dogs. The sampling frequency was 500 Hz. Atrioventricular block was induced by formaldehyde injection into the atrioventricular node. The left anterior descending coronary artery was occluded for 60 minutes under ventricular pacing (140 stimuli/min) followed by reperfusion. Ventricular tachycardias were obtained during reperfusion and during left stellate ganglion stimulation. After visual selection, a total of 97 segments of 2,048 samples (4.096 seconds) were extracted and classified as 67 MVTs and 30 PVTs. A parameter based on the cycle length variability was defined in the second scale of the WT decomposition, normalized by its mean value. Similar assessment of cycle length variability was performed based on the detection of the point of most rapid change in potential with a negative slope in excess of -0.5 mV/ms in each individual electrogram to test the accuracy of the results obtained with the WT parameter. The WT parameter correctly identified 97% MVT and 83.3% PVT segments, for an overall accuracy of 92.8%. Beat-by-beat epicardial maps of MVT displayed a cluster of sites of initial activation close to the reperfusion area, while the sites of breakthrough from beats during PVT were much more dispersed over both ventricles. A strong and significant correlation was found between the number of electrodes with the earliest epicardial activation and the WT parameter (r = .78, P < .0001). To test the accuracy of the results obtained, a comparison was performed between the WT parameter (0.082 +/- 0.007) and the cycle length variability, estimated as the normalized standard deviation of the intervals between individual electrograms (0.076 +/- 0.006). No significant differences were shown (P = .0022), and a strong linear correlation was found between both measurements (Pearson correlation coefficient, .966). It is concluded that WT analysis discriminated accurately between MVT and PVT, and a quantitative relation was found with the spatial dispersion of sites of earliest epicardial activation. The WT results strongly correlated with those obtained by another method of estimating cycle length variability. Methodologically, the strength of the WT lies in the complementary information that could be extracted from the processing of electrograms to enhance the detection/discrimination of different types of arrhythmias.

Animals↗

Spectral analysis of electrograms during ventricular tachycardia in a canine model: relation with epicardial isochronal maps.

The purpose of this study was to assess the capability of magnitude-squared coherence and bicoherence to differentiate monomorphic ventricular tachycardia (MVT) and polymorphic ventricular tachycardia (PVT) in a canine model and to relate these results to the epicardial isochronal maps on a beat-to-beat basis. Unipolar electrograms were simultaneously recorded from the surface of both ventricles with a 127-lead sock electrode array in 12 open-chest anesthetized dogs. The sampling frequency was 500 Hz. Atrioventricular block was induced by formaldehyde injection into the atrioventricular node. The left anterior descending coronary artery was occluded for 60 minutes under ventricular pacing (140 beats/min). During reperfusion, 12 MVT episodes lasting more than 42 seconds were recorded. Left stellate ganglion stimulation induced five PVT episodes lasting more than 42 seconds. Each of these recordings was divided into seven segments of 3,072 points (6.144 seconds). After visual selection, 104 segments were extracted and classified as 73 MVT and 31 PVT segments. Magnitude-squared coherence was estimated as the cross-spectrum from two epicardial signals (on the right and left ventricles, respectively), normalized with the respective autopower spectrum. Bicoherence was estimated as the bispectrum normalized with the autopower spectrum. Magnitude-squared coherence correctly identified 96% of MVT and 81% of PVT segments for a total accuracy of 91%. Bicoherence estimated with the left ventricular lead correctly identified 100% of MVT and 77% of PVT segments with an accuracy of 93%. Beat-to-beat epicardial maps of MVT displayed a cluster of sites of origin close to the reperfusion area, while the sites of origin from beats during PVT were much more dispersed over both ventricles. A strong and significant correlation was found between the number of electrodes with the earliest epicardial activation and coherence (r = .76, P < .0001) and bicoherence (r = .68, P < .0001), respectively. A high and significant correlation was also found between both spectral estimators (r = .74, P < .0001). Coherence and bicoherence discriminated accurately between MVT and PVT. Coherence achieved better results compared with bicoherence. Coherence and bicoherence measurements showed a quantitative relation with the spatial dispersion of the sites of origin. Both spectral techniques seemed powerful enough to be used in the development of implantable devices.

Animals↗