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Locating Ectopic Foci on a Cylinder

Journal article published in 2003 by Pawel Kuklik ORCID, Jan Jj Zebrowski
This paper is available in a repository.
This paper is available in a repository.

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Preprint: policy unknown
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Postprint: policy unknown
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Abstract

Arrhythmia is a condition in which an additional ectopic pacemaker is present in the tissue of the heart. Localization of ectopic foci is essential for successful radio-frequency ablation, an important surgical way of treating arrhythmia. In one of the possible mechanisms, arrhythmia induced by an ectopic foci located in one of the main blood vessels leading out or onto the heart. The therapeutic procedure in this case is usually ablation of the whole junction of the blood vessel with heart wall. In this way, whatever excitation occurs inside the vessel, it cannot penetrate the ventricles perturbing their contraction cycle. Such an ablation procedure is long and burdened with the risk of the perforation. A more safe method would involve the localization of the source of the excitation (i.e. the ectopic foci) and its ablation. The methods used in cardiology at present involve complicated localization systems and are time-consuming with the patient spending a long time on the operating table. Recently, Hall and Glass have developed numerical methods which allow to quickly to model the localization of the ectopic foci in a flat, square sample of an inhomogeneous medium. Here, we demonstrate an extension of this model for the case of a cylinder containing an ectopic foci, that can be a model of a blood vessel with the source of the ectopic beat inside it. Three methods of localization are implemented. Standard electrodes containing several active tips are used to stimulate the medium locally and locate the foci judging from the reaction of the system. The first one uses electrode activation times to compute the location of the ectopic site. The second one localizes it by measuring the resetting response of the foci, and the third one, uses wavefront curvature. Specifically for the cylindrical geometry of the blood vessel, we developed a localization procedure that allows to quickly localize the pacemaker.