Atrial electrograms are often used to gain understanding on the development of atrial fibrillation (AF). Using such electrograms, cardiologists can reconstruct how the depolarization wave-front propagates across the atrium. Knowing the exact moment at which the depolarization wavefront in the tissue reaches each electrode is an important aspect of such reconstruction. A common way to determine the LAT is based on the steepest deflection (SD) of the individual electrograms. However, the SD annotates each electrogram individually and is expected to be more prone to errors compared to approaches that would employ the data from the surrounding electrodes to estimate the LAT. As electrograms from neighboring electrodes tend to have rather similar morphology up to a delay, we propose in this paper to use the cross-correlation to find the pair-wise relative delays between electrograms. Instead of only using the direct neighbors we consider the array as a graph and involve higher order neighbors as well. Using a least-squares method, the absolute LATs can then be estimated from the calculated pair-wise relative delays. Simulated and clinically recorded electrograms are used to evaluate the proposed approach. From the simulated data it follows that the proposed approach outperforms the SD approach.@en

In this study, we propose a novel approach for estimation of local activation times (LATs) in fractionated electrograms. Using an electrophysiological tissue model, we first formulate the electrogram array as a convolution of transmembrane currents with a distance kernel. These currents are more local activities and less affected by the heterogeneity in the tissue compared to electrograms. We then deconvolve the distance kernel with the electrograms to reconstruct the transmembrane current. To stabilize the solution of this ill-posed deconvolution, we use spatio-temporal total variation as a regularization. This helps to preserve sharp spatial and temporal deflections in the currents that are of higher importance in LAT estimation. Finally, the maximum negative slope of the reconstructed transmembrane currents are used to estimate the LATs. Instrumental comparison to two reference approaches shows that the proposed approach performs better in estimating the LATs in fractionated electrograms.@en

Finding the hidden parameters of the cardiac electrophysiological model would help to gain more insight on the mechanisms underlying atrial fibrillation, and subsequently, facilitate the diagnosis and treatment of the disease in later stages. In this work, we aim to estimate tissue conductivity from recorded electrograms as an indication of tissue (mal)functioning. To do so, we first develop a simple but effective forward model to replace the computationally intensive reaction-diffusion equations governing the electrical propagation in tissue. Using the simplified model, we present a compact matrix model for electrograms based on conductivity. Subsequently, we exploit the simplicity of the compact model to solve the ill-posed inverse problem of estimating tissue conductivity. The algorithm is demonstrated on simulated data as well as on clinically recorded data. The results show that the model allows to efficiently estimate the conductivity map. In addition, based on the estimated conductivity, realistic electrograms can be regenerated demonstrating the validity of the model.

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