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Mitral valve reconstruction with artificial chordae: How to secure the desired length? 二尖瓣人工索重建:如何确保所需长度?
Pub Date : 2007-09-01 DOI: 10.1055/S-2008-1037791
M. Krane, E. Braun, H. Mayer, A. Knoll, R. Bauernschmitt, R. Lange
The use of sutures as artificial chordae is widely established in mitral valve reconstruction. After the correct length of the chordae is determined by saline injection, there is a variety of methods to secure that length before tying surgical knots. We investigated the amount of damage posed by applying a haemoclip or a pean clamp and by using a knot-pusher. No differences in breaking forces were found, if a pean clamp was applied, with or without the use of a knot-pusher. (control group: 36 plusmn 4.4 N; Pean: 37.5 plusmn 4.7 N; control group + knotpusher:38.6 plusmn 5 N; pean + knot-pusher: 37.5 plusmn 4.2 N). Using a haemoclip significantly decreased the breaking forces to 12.9 plusmn 14.6 N compared to control group (p<0.01). The length can be safely secured by applying a pean clamp. Haemoclips should not be used on artificial chordae.
缝合线作为人工索索在二尖瓣重建中已被广泛应用。在通过生理盐水注射确定正确的脊索长度后,在打结之前有多种方法来确保该长度。我们调查了使用血夹或豌豆夹和使用结推器造成的损伤量。如果使用或不使用打结器,则没有发现断裂力的差异。(对照组:36±4.4 N;Pean: 37.5±4.7 N;对照组+推结器:38.6±5 N;与对照组相比,使用血夹可显著降低断裂力至12.9 plusmn 14.6 N (p<0.01)。长度可以安全地通过应用一个豌豆夹固定。血夹不应用于人工索。
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引用次数: 2
ECG signal quantization effects in the analysis of atrial fibrillation 心电信号量化在房颤分析中的作用
Pub Date : 2007-09-01 DOI: 10.1109/CIC.2007.4745526
C. Vayá, J. J. Rieta
During last years spectral analysis techniques applied to the ECG have contributed to the knowledge and management of atrial fibrillation (AF). In this matter, it is proved the utility of parameters extracted from the atrial activity (AA) in the time-frequency domain for episode analysis and characterization. These techniques are mostly applied to high resolution 12-lead ECGs. Nevertheless, these high resolution recordings are not always available in the clinical practice and recordings from low resolution acquisition systems, e.g. Holter systems, must be used instead. In this work we analyze the effects of ECG quantization on the AA extraction quality carried out by one of the most recent techniques, independent component analysis (ICA), and the suitability of time-frequency parameters in low resolution recordings.
在过去的几年里,频谱分析技术应用于心电图,有助于了解和管理心房颤动(AF)。在这个问题上,证明了从心房活动(AA)中提取的参数在时频域中用于事件分析和表征的实用性。这些技术主要应用于高分辨率12导联心电图。然而,在临床实践中,这些高分辨率的记录并不总是可用的,必须使用低分辨率采集系统的记录,例如霍尔特系统。在这项工作中,我们分析了心电量化对最新技术之一独立分量分析(ICA)进行的AA提取质量的影响,以及时频参数在低分辨率记录中的适用性。
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引用次数: 2
Using inverse electrocardiography to image myocardial infarction 用逆心电图成像心肌梗死
Pub Date : 2007-09-01 DOI: 10.1109/CIC.2007.4745450
Fady Dawoud
We propose to use methods of inverse electrocardiography (iECG) to compete in the 2007 Computers in Cardiology Challenge, which aims to delineate the location and extent of old myocardial infarct from body-surface potential maps (BSPMs) combined with anatomical imaging information. The provided 120-electrode BSPM data and MRI images were used to calculate epicardial potentials and isochrones of activation. A method was used to define the location and extent of scar tissue based on the morphology of computed epicardial electrograms. Negative Q wave deflection followed by R wave on the left ventricular surface corresponded well with the location of the scar as determined by the gold standard in the two training cases. iECG shows promise as a non-invasive imaging tool to quantitatively characterize location and extent of chronic infarcts.
我们建议使用逆心电图(iECG)方法参加2007年心脏病学计算机挑战赛,该挑战赛旨在通过体表电位图(BSPMs)结合解剖成像信息来描绘陈旧性心肌梗死的位置和范围。利用提供的120个电极BSPM数据和MRI图像计算心外膜电位和激活等时线。采用一种基于心外膜电图形态的方法来确定瘢痕组织的位置和范围。在两个训练病例中,左心室表面的负Q波偏转后的R波与金标准确定的疤痕位置吻合良好。iECG有望作为一种非侵入性成像工具来定量表征慢性梗死的位置和范围。
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引用次数: 15
Assessment of left atrial function using multi-slice CT images 多层螺旋CT图像评价左心房功能
Pub Date : 2007-09-01 DOI: 10.1109/CIC.2007.4745427
W. Hu, M. Wu, H. Tsao, C. Lin, L. Shyu, J. Wang
The function of left atrium can be accurately estimated non-invasively using 4D CT cardiac images. A self-developed image analysis program will first reconstruct 3D volume of heart. Then, one may re-sample images for accurately deleting the 4 pulmonary veins from the atrium and set the boundary. With the prior processed information, the active contour methodology and seed regional growth methodology were implemented to delineate the atrial contour. With a calibration standard of 500 ml saline with contrast medium in bag, both methods were able to estimate volume within 5% of error. Thirty sets of patientpsilas CT cardiac images that were acquired at 30% and 90% of RR interval. The dimension of pulmonary veins and the left atrial volume was evaluated. The contractility of pulmonary vein and the ejection fraction (EF) of atrium was calculated. The result shows that the left atrium with a larger volume will have a poor ejection fraction.
利用4D CT心脏图像可以无创准确估计左心房功能。自行开发的图像分析程序将首先重建心脏的三维体积。然后,重新采样图像,准确地从心房中删除4条肺静脉,并设置边界。利用先验处理的信息,采用活动轮廓法和种子区域生长法对心房轮廓进行圈定。以500 ml生理盐水和对照剂为标准品,两种方法均能在5%的误差范围内估计体积。30组患者分别在30%和90%的RR间期获得CT心脏图像。测量肺静脉尺寸及左房容积。计算肺静脉收缩力和心房射血分数(EF)。结果表明,左心房容量越大,射血分数越低。
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引用次数: 8
Virtual heart: Simulation-based cardiac physiolgy for education 虚拟心脏:基于模拟的心脏生理学教育
Pub Date : 2007-09-01 DOI: 10.1109/CIC.2007.4745422
V. Hurmusiadis
An investigation into the technical feasibility of computer based interactive simulation of the heart was conducted. The project is currently at prototype development phase, which is focused on the development of a virtual heart organ. The prototype will be customized for clinical skills training for interventional cardiology and electrophysiology, as well as for general cardiology education. Further development will incorporate an interface for handling catheter insertion for cardiac ablation and pacing.
对基于计算机的交互式心脏仿真技术的可行性进行了探讨。该项目目前处于原型开发阶段,重点是开发虚拟心脏器官。该原型将被定制用于介入心脏病学和电生理学的临床技能培训,以及普通心脏病学教育。进一步的开发将包括处理心脏消融和起搏导管插入的接口。
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引用次数: 11
Non-invasive, high-density mapping of human atrial fibrillation - introduction and illustration of a novel diagnostic tool 人类房颤的非侵入性高密度测绘-一种新的诊断工具的介绍和说明
Pub Date : 2007-09-01 DOI: 10.1109/CIC.2007.4745505
M. Guillem, A. Climent, D. Husser, J. Millet, A. Bollmann
Electrical atrial activation during atrial fibrillation shows an uncoordinated pattern. Invasive studies and computer models have shown that functional and anatomical barriers can sustain atrial fibrillation. Mechanisms involved in the fibrillatory process are multiple wave reentry, rotors and spiral waves. We have developed a new diagnostic tool with the aim to characterize electrical activation patterns during atrial fibrillation from the body surface. Non-invasive high density mapping using 56 surface electrodes placed on the chest and back of six patients with persistent atrial fibrillation was performed. For the first time, we observed different activation patterns of atrial fibrillation from the body surface: single or multiple wavefronts with different degrees of repeatability. Further study of the activation patterns could be useful in the diagnosis and individual selection of the best treatment with atrial fibrillation.
心房电激活在心房颤动期间显示一个不协调的模式。侵入性研究和计算机模型表明,功能和解剖障碍可以维持心房颤动。参与纤颤过程的机制有多波再入、旋波和螺旋波。我们开发了一种新的诊断工具,目的是从体表表征心房颤动期间的电激活模式。在6例持续性心房颤动患者的胸部和背部放置56个表面电极,进行非侵入性高密度测绘。我们首次从体表观察到心房颤动的不同激活模式:单个或多个波前具有不同程度的重复性。进一步研究激活模式可能有助于房颤的诊断和个体选择最佳治疗方法。
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引用次数: 4
Improvement of an extended Kalman filter power line interference suppressor for ECG signals 一种扩展卡尔曼滤波电力线干扰抑制器的改进
Pub Date : 2007-09-01 DOI: 10.1109/CIC.2007.4745545
L. D. Avendaño-Valencia, L. E. Avendaño, J. Ferrero, G. Castellanos-Domínguez
The powerline interference reduction in ECG records is a challenging problem which is still open for research. The powerline signal, measured directly from the transmission line may have amplitude, phase and frequency variations. These reasons make the classical filtering methods sub-optimal in the powerline interference reduction. We propose a tracking method based on Kalman filtering which uses an state space model for the noisy signal and allows adequate discrimination between the ECG signal and the perturbation, even during non-stationarities. The parameters of this algorithm are optimized via genetic algorithms, obtaining a set of values that give it a mean correlation index on the QT database over 0,99.
减少电力线对心电记录的干扰是一个具有挑战性的问题,仍有待进一步研究。直接从传输线测得的电力线信号可能有幅度、相位和频率的变化。这些原因使得传统滤波方法在降低电力线干扰方面不是最优的。我们提出了一种基于卡尔曼滤波的跟踪方法,该方法对噪声信号使用状态空间模型,即使在非平稳状态下也能充分区分心电信号和扰动。该算法的参数通过遗传算法进行优化,得到一组值,使其在QT数据库上的平均相关指数大于0,99。
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引用次数: 31
Three different algorithms for identifying patients suffering from atrial fibrillation during atrial fibrillation free phases of the ECG 三种不同的算法识别心房颤动患者在心电图无心房颤动阶段
Pub Date : 2007-09-01 DOI: 10.1109/CIC.2007.4745607
N. Kikillus, G. Hammer, N. Lentz, F. Stockwald, A. Bolz
The paper presents and compares three different methods to detect atrial fibrillation using algorithms. Each of these algorithms can identify patients suffering from atrial fibrillation even if there is no atrial fibrillation visible on the ECG. All methods are based on RR-intervals; thus, only a single channel ECG is required. These algorithms have been tested using the MIT-BIH atrial fibrillation database and the MIT-BIH normal sinus rhythm database. The sensitivity and specificity of method 1 is 91.5% and 96.9% respectively. Method 2 results in a sensitivity of 93.3% and a specificity of 92.8% and method 3 in a sensitivity of 94.1% and a specificity of 93.4%. Even if an atrial fibrillation burden of 0% is assumed, the sensitivity still proves satisfactory (sensitivity of method 1, 2 and 3 is 82.9%, 96.3% and 94.1%, respectively).
本文介绍并比较了三种不同的方法来检测心房颤动的算法。这些算法中的每一个都可以识别患有心房颤动的患者,即使在ECG上没有可见的心房颤动。所有方法都基于rr区间;因此,只需要一个单通道ECG。这些算法已经使用MIT-BIH房颤数据库和MIT-BIH正常窦性心律数据库进行了测试。方法1的灵敏度为91.5%,特异度为96.9%。方法2的灵敏度为93.3%,特异性为92.8%;方法3的灵敏度为94.1%,特异性为93.4%。即使假定房颤负担为0%,灵敏度仍然令人满意(方法1、方法2和方法3的灵敏度分别为82.9%、96.3%和94.1%)。
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引用次数: 23
Separating the atrial and ventricular components in atrial fibrillation. Are 64 leads better than 12? 分离心房和心室成分心房颤动。64条线索比12条好吗?
Pub Date : 2007-09-01 DOI: 10.1109/CIC.2007.4745476
A. J. Haigh, A. Murray, P. Langley
It is important to be able to separate the atrial activity from the dominant ventricular activity of the body surface ECG signals in atrial fibrillation so that the effect of therapies such as drug cardioversion and ablation can be adequately assessed. Principal Component Analysis (PCA) and Independent Component Analysis (ICA) are algorithms which can be used but their application has been limited to standard 12-lead ECG recordings. Our aim was to investigate whether better separation of the atrial and ventricular activities could be achieved using additional leads. We applied PCA and ICA to ECG recordings of 12 and 64 leads in 5 patients in atrial fibrillation. We measured and compared between the 12 lead and 64 lead analyses the amplitude of residual ventricular QRS which remained in the separated atrial activity and the dominant fibrillatory frequency. We found that there was little difference between 12 and 64 leads in separating the atrial and ventricular activity.
重要的是能够将心房活动与体表心电图信号的主要心室活动分离开来,以便充分评估药物心律转复和消融等治疗的效果。主成分分析(PCA)和独立成分分析(ICA)是可以使用的算法,但它们的应用仅限于标准的12导联心电记录。我们的目的是研究是否可以使用额外的导联更好地分离心房和心室活动。我们对5例房颤患者的12根导联和64根导联进行了PCA和ICA分析。我们测量并比较了12导联和64导联分析在分离心房活动和主要颤动频率中剩余心室QRS的幅度。我们发现12导联和64导联在分离心房和心室活动方面差别不大。
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引用次数: 4
Comparison of three methods to estimate regional wall motion on the Evalechocard database of echocardiographic image sequences 超声心动图图像序列Evalechocard数据库中三种估计区域壁运动的方法的比较
Pub Date : 2007-09-01 DOI: 10.1109/CIC.2007.4745428
Nadjia Kachenoura, Frédérique Frouin, Laurent Sarry, C. Tilmant, Thomas Corpetti, H. Guillemet, O. Nardi, A. Delouche, Benoit Diebold
The objective of this paper is to propose a framework in order to make the comparison of image processing algorithms effective. This framework was applied to three methods developed for automated regional wall motion scoring and they were compared to a reference scoring on a database of echocardiographic images (Evalechocard). Firstly, 200 annotated echocardiograms on hundred patients were used for the training stage; secondly the algorithms were blinded tested on 100 additional echocardiograms. Results obtained by the three methods are presented, using different metrics to compare them. This evaluation procedure enables a real progress in the assessment of each method and helps to understand its limits and its potentialities. Test results have shown the difficult cases and could be further used to improve the methods. Moreover the annotated database is now open to any research group who wants to test its own methods.
本文的目的是提出一个框架,以便有效地比较图像处理算法。该框架应用于三种用于自动区域壁运动评分的方法,并将它们与超声心动图图像数据库(Evalechocard)的参考评分进行比较。首先,使用100例患者200张带注释的超声心动图作为训练阶段;其次,在另外100张超声心动图上对算法进行盲法测试。给出了三种方法得到的结果,并用不同的度量对它们进行比较。这一评价程序能够在评价每一种方法方面取得真正的进展,并有助于了解其局限性和潜力。测试结果显示了困难的情况,可以进一步用于改进方法。此外,这个带注释的数据库现在对任何想要测试自己方法的研究小组开放。
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引用次数: 0
期刊
2007 Computers in Cardiology
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