Inverse reconstruction of epicardial potentials improved by vectorcardiography and realistic potentials

The inverse problem of electrocardiography is to reconstruct electrical activity at the level of the epicardium from body-surface electrograms and a patient-specific torsoheart geometry. This is complicated by the ill-posedness of the inverse problem, making the reconstruction imperfect. Previously, we have shown that the use of realistic epicardial training electrograms can improve reconstruction quality in silico. Here, we apply this method in a patient and compare the resulting computed electrograms with intracardiac measurements. Additionally, we utilize a new method that yields further improvements by incorporating characteristics of vectorcardiographic information. Patient-specific vectorcardiographic optimization combined with training data created on a patient-specific heart improves morphologies of the reconstructed epicardial potentials. This underlines the need for constraints based on real patient-specific information in the regularization of the electrocardiographic inverse problem.