Estimation of epicardial activation maps from intravascular recordings

Multielectrode catheters provide a percutaneous means of recording activation near the epicardium but only for a relatively small number of sites that are restricted to the major coronary vessels. We have applied a statistical signal processing technique to estimate the value of activation time over the entire epicardium (490 sites) from leadsets consisting of 4 to 40 sites aligned with major branches of the coronary veins. We tested this method using data from high-resolution epicardial mapping from six dog hearts and 153 activation sequences. A study including data from both normal and infarcted dog hearts yielded estimates of activation time, with mean correlation coefficients ranging from 0.97 to 0.84 and achieved localization of earliest site of activation to within 3 to 15 mm, depending on training parameters and leadset. These results suggest that with 10 to 15 catheter-mounted electrodes, it may be possible to reconstruct epicardial activation maps from percutaneous recordings.