0000000000116864
AUTHOR
Renzo Antolini
showing 24 related works from this author
Determination of Synchronization of Electrical Activity in the Heart by Shannon Entropy Measure
2005
In this paper we propose a new index of synchronization for the study of heart’s electrical activity during atrial fibrillation (AF). The index relies on the measure of the time delays between correspondent activations in two atrial electrograms and on the characterization of their dispersion by a measure of Shannon Entropy. The algorithm was validated on simulated signals mimicking different degree of synchronization. Results showed the index was able to discriminate among different levels of organization, provided that it works on series of at least 50 activations (time resolution of almost 10 sec during AF). Moreover, we applied the algorithm to real bipolar electrograms, obtained from a…
Quantification of synchronization during atrial fibrillation by Shannon entropy: Validation in patients and computer model of atrial arrhythmias
2005
Atrial fibrillation (AF), a cardiac arrhythmia classically described as completely desynchronized, is now known to show a certain amount of synchronized electrical activity. In the present work a new method for quantifying the level of synchronization of the electrical activity recorded in pairs of atrial sites during atrial fibrillation is presented. A synchronization index (Sy) was defined by quantifying the degree of complexity of the distribution of the time delays between sites by Shannon entropy estimation. The capability of Sy to discriminate different AF types in patients was assessed on a database of 60 pairs of endocardial recordings from a multipolar basket catheter. The analysis…
Wave similarity mapping shows the spatiotemporal distribution of fibrillatory wave complexity in the human right atrium during paroxysmal and chronic…
2005
Introduction: The complexity of waveforms during atrial fibrillation may reflect critical activation patterns for the arrhythmia perpetuation. In this study, we introduce a novel concept of map, based on the analysis of the wave morphology, which gives a direct evidence in the human right atrium on the spatiotemporal distribution of fibrillatory wave complexity in paroxysmal (PAF) and chronic (CAF) atrial fibrillation. Methods and Results: Electrograms were recorded from a 64-electrode catheter in the right atrium of 15 patients during PAF (n = 8) and CAF (n = 7). Wave similarity maps were constructed by calculating the degree of morphological similarity of activation waves (S) at each atri…
A method for quantifying atrial fibrillation organization based on wave-morphology similarity
2002
A new method for quantifying the organization of single bipolar electrograms recorded in the human atria during atrial fibrillation (AF) is presented. The algorithm relies on the comparison between pairs of local activation waves (LAWs) to estimate their morphological similarity, and returns a regularity index (/spl rho/) which measures the extent of repetitiveness over time of the detected activations. The database consisted of endocardial data from a multipolar basket catheter during AF and intraatrial recordings during atrial flutter. The index showed maximum regularity (/spl rho/=1) for all atrial flutter episodes and decreased significantly when increasing AF complexity as defined by W…
Need of causal analysis for assessing phase relationships in closed loop interacting cardiovascular variability series
2003
The phase spectra obtained by the classical closed loop autoregressive model (2AR) and by an open loop autoregressive model (ARXAR) were compared to shed light on the need of introducing causality in the assessment of the delay between RR and arterial pressure oscillations. The reliability of the two approaches was tested in simulation and real data setting. In simulation, the coupling strength of a bivariate closed loop process was adjusted to obtain a range of working conditions from open to closed loop. In open loop condition, 2AR and ARXAR phases were comparable and in agreement with the imposed delay. In closed loop condition, ARXAR model returned the imposed delays, while 2AR showed a…
A stochastic approach for automatic registration and fusion of left atrial electroanatomic maps with 3D CT anatomical images.
2007
The integration of electroanatomic maps with highly resolved computed tomography cardiac images plays an important role in the successful planning of the ablation procedure of arrhythmias. In this paper, we present and validate a fully-automated strategy for the registration and fusion of sparse, atrial endocardial electroanatomic maps (CARTO maps) with detailed left atrial (LA) anatomical reconstructions segmented from a pre-procedural MDCT scan. Registration is accomplished by a parameterized geometric transformation of the CARTO points and by a stochastic search of the best parameter set which minimizes the misalignment between transformed CARTO points and the LA surface. The subsequent …
Assessing Causality in normal and impaired short-term cardiovascular regulation via nonlinear prediction methods
2009
We investigated the ability of mutual nonlinear prediction methods to assess causal interactions in short-term cardiovascular variability during normal and impaired conditions. Directional interactions between heart period (RR interval of the ECG) and systolic arterial pressure (SAP) short-term variability series were quantified as the cross-predictability (CP) of one series given the other, and as the predictability improvement (PI) yielded by the inclusion of samples of one series into the prediction of the other series. Nonlinear prediction was performed through global approximation (GA), approximation with locally constant models (LA0) and approximation with locally linear models (LA1) …
Exploring directionality in spontaneous heart period and systolic pressure variability interactions in humans: implications in the evaluation of baro…
2004
Although in physiological conditions RR interval and systolic arterial pressure (SAP) are likely to interact in a closed loop, the traditional cross-spectral analysis cannot distinguish feedback (FB) from feedforward (FF) influences. In this study, a causal approach was applied for calculating the coherence from SAP to RR ( Ks-r) and from RR to SAP ( Kr-s) and the gain and phase of the baroreflex transfer function. The method was applied, compared with the noncausal one, to RR and SAP series taken from 15 healthy young subjects in the supine position and after passive head-up tilt. For the low frequency (0.04–0.15 Hz) spectral component, the enhanced FF coupling ( Kr-s = 0.59 ± 0.21, signi…
Role of causality in the evaluation of coherence and transfer function between heart period and systolic pressure in humans
2004
To elicit the effects of considering causality in the study of the interactions between RR interval and systolic pressure (SP) variability, the traditional noncausal cross-spectral analysis was compared with a causal method able to separate the two arms of the RR-SP regulatory loop. Estimates of coherence (K) and causal coherences from SP to RR (Ksr) and from RR to SP (Krs), and of noncausal (G) and causal (Gsr) baroreflex gain were evaluated at 0.1 Hz in 10 healthy young subjects in the supine position and after head-up tilt. While K was high in both conditions, at rest Ksr was significantly lower than Krs. After tilt, Ksr increased and Krs decreased significantly. With respect to G, Gsr w…
Evidence of unbalanced regulatory mechanism of heart rate and systolic pressure after acute myocardial infarction
2002
The interactions between systolic arterial pressure (SAP) and R-R interval (RR) fluctuations after acute myocardial infarction (AMI) were investigated by measures of synchronization separating the feedback from the feedforward control and capturing both linear and nonlinear contributions. The causal synchronization, evaluating the ability of RR to predict SAP (χs/t) or vice versa (χt/s), and the global synchronization (χ) were estimated at rest and after head-up tilt in 35 post-AMI patients, 20 young and 12 old. Significance and nonlinearity of the coupling were assessed by surrogate data analysis. Tilting increased the number of young subjects in which RR-SAP link was significant (from 17…
Principal component analysis and cluster analysis for measuring the local organisation of human atrial fibrillation
2001
The distribution of atrial electrogram types has been proposed to characterise human atrial fibrillation. The aim of this study was to provide computer procedures for evaluating the local organisation of intracardiac recordings during AF as an alternative to off-line manual classification. Principal components analysis (PCA) reduced the data set to a few representative activations, and cluster analysis (CA) measured the average dissimilarity between consecutive activations of an intracardiac signal. The data set consisted of 106 bipolar signals recorded on 11 patients during electrophysiological studies for catheter ablation. Performances of PCA and CA in distinguishing between organised (t…
Causal cross-spectral analysis of heart rate and blood pressure variability for describing the impairment of the cardiovascular control in neurally m…
2006
A causal approach to the calculation of coherence and transfer function between systolic pressure (SP) and RR interval variability was applied in eight patients and eight control subjects during prolonged tilt test for investigating the impairment of cardiovascular control related to neurally mediated syncope. The causal analysis showed a depressed baroreflex regulation in resting patients, with reduced gain and increased latency from SP to RR, and a drop of the baroreflex coupling immediately before syncope. These findings, which were not elicited by traditional cross-spectral analysis, strongly suggest the use of the causal approach for the study of syncope mechanisms. © 2006 IEEE.
Local electrical characterisation of human atrial fibrillation
2002
The rate of success of radio-frequency catheter ablation in the treatment of atrial fibrillation may be significantly improved by evaluating the local electrical properties of the atrial tissue. The aim of this study is the development of an automatic procedure for the characterisation of the local electrical activity during atrial fibrillation and the comparison of its performance with the manual analysis. The adopted procedures were the semi-automatic measurement of the local fibrillation intervals (A-A intervals) and the manual electrogram classification following the criteria suggested by Wells (1978) or Konings (1997). Two methods have been used: Principal Component Analysis and Cluste…
Causal transfer function analysis to describe closed loop interactions between cardiovascular and cardiorespiratory variability signals
2004
Although the concept of transfer function is intrinsically related to an input-output relationship, the traditional and widely used estimation method merges both feedback and feedforward interactions between the two analyzed signals. This limitation may endanger the reliability of transfer function analysis in biological systems characterized by closed loop interactions. In this study, a method for estimating the transfer function between closed loop interacting signals was proposed and validated in the field of cardiovascular and cardiorespiratory variability. The two analyzed signals x and y were described by a bivariate autoregressive model, and the causal transfer function from x to y w…
Investigating the level of significance of the coherence function in cardiovascular variability analysis
2002
Although the presence of significant coupling between cardiovascular variability series is usually verified according to the threshold value of 0.5 in the coherence function (CF), spectral estimator parameters should also be considered. In this study, the surrogate data technique was introduced to define the level of significance of the CF. The proposed method determined a frequency-dependent threshold over which the hypothesis of zero coherence was rejected. The weighted covariance method and the autoregressive method were used to estimate the CF on simulated series with different degrees of linear coupling and on real cardiovascular data. The threshold was dependent on the type and parame…
Isolation of the left atrial surface from cardiac multi-detector CT images based on marker controlled watershed segmentation
2006
The delineation of left atrium (LA) and pulmonary veins (PVs) anatomy from high resolution images holds importance for atrial fibrillation (AF) investigation and treatment. In this study, a semiautomatic segmentation procedure for LA and PVs inner surface from contrast enhanced CT data was developed. The procedure consists of a three dimensional marker controlled watershed segmentation applied to the external morphological gradient, followed by variable threshold surface extraction from the original intensity image. A preliminary anisotropic non-linear filtering was implemented to improve the S/N ratio of CT images. The performance of segmentation was evaluated on cardiac CT scans of 12 AF …
Small-sample characterization of stochastic approximation staircases in forced-choice adaptive threshold estimation
2007
Despite the widespread use of up—down staircases in adaptive threshold estimation, their efficiency and usability in forced-choice experiments has been recently debated. In this study, simulation techniques were used to determine the small-sample convergence properties of stochastic approximation (SA) staircases as a function of several experimental parameters. We found that satisfying some general requirements (use of the accelerated SA algorithm, clear suprathreshold initial stimulus intensity, large initial step size) the convergence was accurate independently of the spread of the underlying psychometric function. SA staircases were also reliable for targeting percent-correct levels far …
Quantitative assessment of regularity and synchronization of intracardiac recordings during human atrial fibrillation
2003
This study proposes the morphology-based evaluation of the regularity (R) and the synchronization (S) of intra-atrial electrograms acquired during atrial fibrillation (AF). R is defined as the degree of repetitiveness over time of the shapes of the activation waves detected in single atrial recordings. S accounts for the simultaneous presence of morphologically similar activation waves in two atrial electrograms, and for the dispersion of the propagation delays between the two sites. Both R and S resulted unitary for normal sinus rhythm and decreased significantly moving from atrial flutter (R=0.93, S=0.88) to AF of increasing complexity class (type I AF: R=0.75, S=0.66; type II AF: R=0.32,…
Morphology-based measurement of activation time in human atrial fibrillation
2003
The measurement of the activation time is crucial to allow the correct automatic analysis and classification of intracardiac electrograms recorded in the human atria during atrial fibrillation (AF). This study proposes a method which accounts for the morphology of bipolar signals. After ventricular artifact removal and activation wave recognition, the fiducial point of the activation wave was set at its local barycentre (LB). The method was tested on a set of 30 AF bipolar recordings of increasing complexity class; its performance was compared with that of the traditional methods of maximum peak (MP) or maximum slope (MS) estimation, taking the manual measurements performed by an expert car…
Experimental approach for testing the uncoupling between cardiovascular variability series
2002
In cardiovascular variability analysis, the significance of the coupling between two series is commonly assessed by defining a zero level on the magnitude-squared coherence (MSC). Although the use of the conventional value of 0.5 does not consider the dependence of MSC estimates on the analysis parameters, a theoretical threshold Tt is available only for the weighted covariance (WC) estimator. In this study, an experimental threshold for zero coherence Te was derived by a statistical test from the sampling distribution of MSC estimated on completely uncoupled time series. MSC was estimated by the WC method (Parzen window, spectral bandwidth B = 0.015, 0.02, 0.025, 0.03 Hz) and by the parame…
Registration and fusion of segmented left atrium CT images with CARTO electrical maps for the ablative treatment of atrial fibrillation
2005
This study aims to extract the interior surface of the left atrium (LA) and pulmonary veins (PVs) from threedimensional tomographic data and to integrate it with LA CARTO electrical maps. The separation of LA and PVs from other overlapping structures of the heart was performed processing 3D CT data by marker-controlled watershed segmentation and surface extraction. CARTO maps were then registered on the L A internal surface by a stochastic optimization algorithm based on simulated annealing. The residual registration error resulted inferior to 3 mm. The integration between electrophysiological and high resolved anatomic information of LA results feasible and may constitute a significant sup…
Synchronization index for quantifying nonlinear causal coupling between RR interval and systolic arterial pressure after myocardial infarction
2002
The analysis of nonlinear couplings among cardiovascular variability series can improve the knowledge of the cardioregulatory mechanism and help to understand how it can be affected by pathologies. In this study, the influences of acute myocardial infarction (AMI) on the causal relationships between the heart period and the arterial pressure were investigated by a nonlinear dynamic approach based on the corrected cross-conditional entropy. Whereas the global synchronization index did not differentiate the post-AMI patients from the young and old control groups, the causal indexes evidenced the impairment of the baroreflex control and showed an increase of the mechanical driving of the RR in…
Spectral decomposition of RR-variability obtained by an open loop parametric model for the diagnosis of neuromediate syncope
2002
The role of the cardiovascular regulatory mechanism in patients with neuromediate syncope (NS) is poorly understood. The aim of this study was to accomplish continuous non-invasive analysis of the baroreflex mechanism in patients during a head-tip tilt-table test (HTT) using an open-loop autoregressive model with exogenous input. The model describes the causal dependence of the RR interval on the systolic arterial pressure (SAP) variability. Thus, RR variability results as the linear composition of SAP-dependent (Pdep) and SAP-independent parts of the RR power (P). Further, the model allows the estimation of the baroreflex gain using the modulus of the transfer function (G) from SAP to RR i…
Quantitative assessment of synchronization during atrial fibrillation by Shannon Entropy characterization of propagation delays
2005
This study introduced a new method for the quantification of the synchronization (S) and the causal verse of activation (S12) in couples of atrial electrograms recorded during atrial fibrillation (AF). The synchronization indexes S and S12 relied on the measure of the propagation delays between coupled activation times in two atrial signals and on the characterization of their dispersion by Shannon-Entropy (SE). S and S12 were validated both on simulated activation time series and endocavitary signals in patients. In simulation, S and S12 were equal to 1 for propagation of one single wavefront in a fully excitable tissue, while they decreased for reentries in partially excitable tissue (S =…