A Novel 3D Camera-Based ECG-Imaging System for Electrode Position Discovery and Heart-Torso Registration

ECG-imaging has been receiving increasing clinical and commercialization interest as a non-invasive technology for computing cardiac electrical activity and facilitating clinical management of heart rhythm disorders. Despite its potential, the standard ECG-imaging pipeline requires thorax imaging for constructing patient-specific heart-thorax geometry – being outside standard-of-care clinical workflow, this component constitutes a major barrier to the clinical adoption of ECG-imaging. The advent of 3D cameras into ECG-imaging workflow to replace thorax imaging has shown promise, although existing works largely neglect the registration between camera-derived thorax models with an individual's heart geometry. In this work, we address this gap with a novel system that generates patient-specific torso geometry using a 3D camera, registers the torso to heart geometry obtained from pre-existing cardiac scans, and optimally deforms the torso to the skin surface of the patient. We evaluated the presented camera-based ECG-imaging system on five patients undergoing ablation of scar-related ventricular tachycardia, where we evaluate both the accuracy of the surface electrode localization and the ECG-imaging solutions in comparison to those obtained from computed tomography based thorax imaging. We further evaluate the use of the presented camera-based patient-specific heart-thorax model versus a generic heart-thorax model, highlighting the importance of the registration between the camera-based thorax models with cardiac scans.