Electroanatomical mapping has become a valuable tool for the diagnosis and treatment of complex arrhythmias. Although the localization capabilities of mapping systems have significantly improved and the amount of intracardiac electrograms (EGMs) recorded during mapping was strongly increased, there is still a lack of suitable analysis algorithms to facilitate diagnosis by biosignal analysis.
In order to help physicians optimizing treatment, the Institute of Biomedical Engineering in Karlsruhe (IBT) is developing new techniques to process, filter and analyze EGMs. On the one hand, this research is focusing on fundamental theories about initiation and maintenance of arrhythmias like atrial flutter and atrial fibrillation. On the other hand it is equally driven by specifiy ideas coming from physician’s side. In any case, development of new algorithms and their applicability to clinical data is an interdisciplinary challenge.
Since state-of-the-art electroanatomical mapping (EAM) systems do not allow for direct implementing and testing of novel algorithms, the Institute of Biomedical Engineering has developed a scheme that allows to process data from all EAM systems currently on the market (CARTO by Biosense Webster, NavX Velocity by St. Jude Medical, Rhythmia by Boston Scientific). The data can be imported and processed using various scripts and functions in MATLAB (MathWorks). For subsequent discussion, a custom made graphical user interface was developed: The Karlsruhe Platform for Analysis and Visualization of Intracardiac Electrograms (KaPAVIE).
KaPAVIE allows for visualization of the cardiac anatomy with all electrogram measurement points. EGMs can be visualized by clicking on the desired electrode, and are displayed synchronously to the surface ECG and an intracardiac reference channel. The results of automated signal analysis are color-coded and projected onto the atrial geometry, so that anatomy and measurement results can easily be related. It also allows to visualize time dynamic processes like activity movies or phase maps in a movie-like manner.
In Karlsruhe, usage of KaPAVIE has intensified the discussion between engineers and physicians, leading to better research outcomes. Other research groups are welcome to use KaPAVIE for free. Please contact publications∂ibt.kit.edu to get in touch!