Author + information
- R.A. Wildhaber1,
- S. Mortier2,
- A. Haeberlin3,
- R. Sweda3,
- D. Bruegger4,
- T. Niederhauser4,
- M. Jacomet4,
- J. Goette4 and
- H. Tanner5
- 1Institute for Human Centered Engineering, Bern University of Applied Sciences, Biel, Switzerland Dept. of Information Technology and Electrical Engineering ETH Zurich, Switzerland
- 2Faculty of Medicine, University of Bern, Switzerland
- 3Department of Cardiology, Inselspital, Bern University Hospital, and University of Bern, Switzerland ARTORG Center for Biomedical Engineering, University of Bern, Switzerland
- 4Institute for Human Centered Engineering, Bern University of Applied Sciences, Biel, Switzerland
- 5Department of Cardiology, Inselspital, Bern University Hospital, and University of Bern, Switzerland
P-waves in surface ECGs are often of minor quality and lead to uncertainties in non-invasive arrhythmia diagnostics. We therefore exploited the advantages of esophageal ECGs (eECG) to improve the diagnosis of atrial arrhythmias.
Esophageal ECGs of 14 patients with supraventricular arrhythmias and 6 healthy subjects were recorded during a pilot study using a multipolar naso-esophageal catheter (ESOFLEX-10S, FIAB). We fused multiple beats under consideration of catheter motions and variations in beat morphology to create a novel 2-D high-resolution eECG representation, which we name esophageal isopotential map (IPM).
IPMs visualize electrical cardiac fields measured in the esophagus as isopotential lines in a 2-D view with the abscissae showing time and the ordinate showing esophageal depth. IPMs show epicardial atrial signals with enhanced signal quality and reveal cardiac propagation speed and its direction. Figures 1 and 2 show IPMs for a healthy subject and a patient with atrial flutter, respectively.
Complementing surface ECGs with IPMs might increase the reliability of non-invasive atrial arrhythmia diagnostics. A trial with intra-cardiac reference measurements for validation is ongoing.