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Novel non-invasive algorithm to identify the origins of re-entry and ectopic foci in the atria from 64-lead ECGs. A computational study

Alday, Erick A. Perez; Colman, Michael A.; Langley, Philip; Zhang, Henggui


Erick A. Perez Alday

Michael A. Colman

Philip Langley

Henggui Zhang


Alexander V Panfilov


Atrial tachy-arrhytmias, such as atrial fibrillation (AF), are characterised by irregular electrical activity in the atria, generally associated with erratic excitation underlain by re-entrant scroll waves, fibrillatory conduction of multiple wavelets or rapid focal activity. Epidemiological studies have shown an increase in AF prevalence in the developed world associated with an ageing society, highlighting the need for effective treatment options. Catheter ablation therapy, commonly used in the treatment of AF, requires spatial information on atrial electrical excitation. The standard 12-lead electrocardiogram (ECG) provides a method for non-invasive identification of the presence of arrhythmia, due to irregularity in the ECG signal associated with atrial activation compared to sinus rhythm, but has limitations in providing specific spatial information. There is therefore a pressing need to develop novel methods to identify and locate the origin of arrhythmic excitation. Invasive methods provide direct information on atrial activity, but may induce clinical complications. Non-invasive methods avoid such complications, but their development presents a greater challenge due to the non-direct nature of monitoring. Algorithms based on the ECG signals in multiple leads (e.g. a 64-lead vest) may provide a viable approach. In this study, we used a biophysically detailed model of the human atria and torso to investigate the correlation between the morphology of the ECG signals from a 64-lead vest and the location of the origin of rapid atrial excitation arising from rapid focal activity and/or re-entrant scroll waves. A focus-location algorithm was then constructed from this correlation. The algorithm had success rates of 93% and 76% for correctly identifying the origin of focal and re-entrant excitation with a spatial resolution of 40 mm, respectively. The general approach allows its application to any multi-lead ECG system. This represents a significant extension to our previously developed algorithms to predict the AF origins in association with focal activities.


Alday, E. A. P., Colman, M. A., Langley, P., & Zhang, H. (2017). Novel non-invasive algorithm to identify the origins of re-entry and ectopic foci in the atria from 64-lead ECGs. A computational study. PLoS Computational Biology, 13(3), e1005270.

Journal Article Type Article
Acceptance Date Jan 24, 2017
Online Publication Date Mar 2, 2017
Publication Date Mar 2, 2017
Deposit Date Nov 30, 2016
Publicly Available Date Mar 2, 2017
Journal PLoS computational biology
Print ISSN 1553-734X
Electronic ISSN 1553-7358
Publisher Public Library of Science
Peer Reviewed Peer Reviewed
Volume 13
Issue 3
Article Number e1005270
Pages e1005270
Keywords Ecology; Modelling and simulation; Computational theory and mathematics; Genetics; Ecology, Evolution, Behavior and systematics; Molecular biology; Cellular and molecular neuroscience
Public URL
Publisher URL
Additional Information This is a copy of an open access article published in: PLoS computational biology, 2017, v.13 issue 3.


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Copyright Statement
© 2017 Alday et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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