www.sci.utah.edu 2012 Medical Motivation: Improve diagnostic accuracy of ECG based early detection of myocardial ischemia in patients at risk of coronary artery disease. Electrocardiographic Characterization of Acute Myocardial Ischemia Kedar Aras Brett Burton Darrell Swenson Scott Youngquist Rob MacLeod Alexey Zaitsev Bonnie Punske Elizabeth Shiu SCI contributors CVRTI contributors School of Medicine Clinical Setting - Patient Evaluation 1 Patient Symptoms 2 ECG Diagnostic Tests Continuous Monitoring Exercise Stress Testing 3 Patient Evaluation ECG Nomenclature ST Elevation ST Depression Normal ST Abnormal ECG Patterns Patient Diagnosis Heart Attack Myocardial Ischemia Acid Reflux Unknown Causes ??? Experimental Setting - Ischemia Characterization 1 Ischemia Profile Supply Demand Ischemia = imbalance between blood supply and metabolic needs of the heart 2 Canine Heart Blood Pump Cannula Electrodes Experiments Measurement of electric fields form the heart during ischemia 3 Electrical Profile of Ischemia High Resolution 3D mapping of Ischemia In Silico Setting - Ischemia Modeling 1 Ischemia Simulation 2 Ischemia simulation to improve patient diagnosis Abnormal ECG Patterns Ischemia Simulation Ischemia Diagnosis YES / NO Patient ECG Diagnostic Tests Extent of Ischemia ST Elevation ST Depression ● Chest Pain ● Shortness of Breath ● Anxiery, Sweating ● Abnormal ECG F o r w a r d P r o b l e m I n v e r s e P r o b l e m Volume Conductor Bioelectric Source Surface Potentials www.sci.utah.edu Patient Treatment