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Myocardial ischemia creates abnormal electrophysiological substrates that can result in life-threatening ventricular arrhythmias. Early clinical identification of ischemia in patients is important to managing their condition. We analyzed electrograms from an ischemia-reperfusion animal model in order to investigate the relationship between myocardial ischemia and variability of electrocardiogram (ECG) multifractality. Ventricular epicardial electropotential maps from the anesthetized pig during LAD ischemia-reperfusion were analyzed using multifractal methods. A new parameter called the singularity spectrum area reference dispersion (SARD) is presented to represent the temporal evolution of multifractality. By contrasting the ventricular epicardial SARD and range of singularity strength (delta alpha) maps against activation-recovery interval (ARI) maps, we found that the dispersions of SARD and dleta alpha increased following the onset of ischemia and decreased with tissue recovery. In addition, steep spatial gradients of SARD and delta alpha corresponded to locations of ischemia, although the distribution of multifractality did not reflect the degree of myocardial ischemia. However, the multifractality of the ventricular epicardial electrograms was useful for classifying the recoverability of ischemic tissue. Myocardial ischemia significantly influenced the multifractality of ventricular electrical activity. Recoverability of ischemic myocardium can be classified using the multifractality of ventricular epicardial electrograms. The location and size of regions of severe ischemic myocardium with poor recoverability is detectable using these methods.

Original publication

DOI

10.1109/TBME.2006.873557

Type

Journal article

Journal

IEEE Trans Biomed Eng

Publication Date

10/2006

Volume

53

Pages

1920 - 1925

Keywords

Animals, Body Surface Potential Mapping, Diagnosis, Computer-Assisted, Electrocardiography, Fractals, Heart Conduction System, Heart Ventricles, Myocardial Ischemia, Pericardium, Swine