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Open AccessArticle

Force Trends and Pulsatility for Catheter Contact Identification in Intracardiac Electrograms during Arrhythmia Ablation

1
Departamento de Eléctrica y Electrónica, Universidad de las Fuerzas Armadas ESPE, Av. General Rumiñahui s/n, 170501 Sangolquí, Ecuador
2
Department of Signal Theory and Communications and Telematic Systems and Computation, Rey Juan Carlos University, Fuenlabrada, 28943 Madrid, Spain
3
Center for Computational Simulation, Universidad Politécnica de Madrid; Boadilla, 28223 Madrid, Spain
4
Universidad Politécnica Salesiana, 010105 Cuenca, Ecuador
5
Arrhythmia Unit, University Clinic Hospital Virgen de la Arrixaca, El Palmar, 30120 Murcia, Spain
*
Author to whom correspondence should be addressed.
Sensors 2018, 18(5), 1399; https://doi.org/10.3390/s18051399
Received: 19 March 2018 / Revised: 25 April 2018 / Accepted: 28 April 2018 / Published: 2 May 2018
(This article belongs to the Section Biosensors)
The intracardiac electrical activation maps are commonly used as a guide in the ablation of cardiac arrhythmias. The use of catheters with force sensors has been proposed in order to know if the electrode is in contact with the tissue during the registration of intracardiac electrograms (EGM). Although threshold criteria on force signals are often used to determine the catheter contact, this may be a limited criterion due to the complexity of the heart dynamics and cardiac vorticity. The present paper is devoted to determining the criteria and force signal profiles that guarantee the contact of the electrode with the tissue. In this study, we analyzed 1391 force signals and their associated EGM recorded during 2 and 8 s, respectively, in 17 patients (82 ± 60 points per patient). We aimed to establish a contact pattern by first visually examining and classifying the signals, according to their likely-contact joint profile and following the suggestions from experts in the doubtful cases. First, we used Principal Component Analysis to scrutinize the force signal dynamics by analyzing the main eigen-directions, first globally and then grouped according to the certainty of their tissue-catheter contact. Second, we used two different linear classifiers (Fisher discriminant and support vector machines) to identify the most relevant components of the previous signal models. We obtained three main types of eigenvectors, namely, pulsatile relevant, non-pulsatile relevant, and irrelevant components. The classifiers reached a moderate to sufficient discrimination capacity (areas under the curve between 0.84 and 0.95 depending on the contact certainty and on the classifier), which allowed us to analyze the relevant properties in the force signals. We conclude that the catheter-tissue contact profiles in force recordings are complex and do not depend only on the signal intensity being above a threshold at a single time instant, but also on time pulsatility and trends. These findings pave the way towards a subsystem which can be included in current intracardiac navigation systems assisted by force contact sensors, and it can provide the clinician with an estimate of the reliability on the tissue-catheter contact in the point-by-point EGM acquisition procedure. View Full-Text
Keywords: arrhythmias; Principal Component Analysis; linear classifiers; tissue-catheter contact; force signals; electrograms arrhythmias; Principal Component Analysis; linear classifiers; tissue-catheter contact; force signals; electrograms
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Rivas-Lalaleo, D.; Muñoz-Romero, S.; Huerta, M.; Erazo-Rodas, M.; Sánchez-Muñoz, J.J.; Rojo-Álvarez, J.L.; García-Alberola, A. Force Trends and Pulsatility for Catheter Contact Identification in Intracardiac Electrograms during Arrhythmia Ablation. Sensors 2018, 18, 1399.

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