Characterizing the transient electrocardiographic signature of ischemic stress using Laplacian Eigenmaps for dimensionality reduction.

OBJECTIVE: Despite a long history of ECG-based monitoring of acute ischemia quantified by several widely used clinical markers, the diagnostic performance of these metrics is not yet satisfactory, motivating a data-driven approach to leverage underutilized information in the electrograms. This study introduces a novel metric for acute ischemia, created using a machine learning technique known as Laplacian eigenmaps (LE), and compares the diagnostic and temporal performance of the LE metric against traditional metrics. METHODS: The LE technique uses dimensionality reduction of simultaneously recorded time signals to map them into an abstract space in a manner that highlights the underlying signal behavior. To evaluate the performance of an electrogram-based LE metric compared to current standard approaches, we induced episodes of transient, acute ischemia in large animals and captured the electrocardiographic response using up to 600 electrodes within the intramural and epicardial domains. RESULTS: The LE metric generally detected ischemia earlier than all other approaches and with greater accuracy. Unlike other metrics derived from specific features of parts of the signals, the LE approach uses the entire signal and provides a data-driven strategy to identify features that reflect ischemia. CONCLUSION: The superior performance of the LE metric suggests there are underutilized features of electrograms that can be leveraged to detect the presence of acute myocardial ischemia earlier and more robustly than current methods. SIGNIFICANCE: The earlier detection capabilities of the LE metric on the epicardial surface provide compelling motivation to apply the same approach to ECGs recorded from the body surface.

Image-based modeling of acute myocardial ischemia using experimentally derived ischemic zone source representations.

BACKGROUND: Computational models of myocardial ischemia often use oversimplified ischemic source representations to simulate epicardial potentials. The purpose of this study was to explore the influence of biophysically justified, subject-specific ischemic zone representations on epicardial potentials. METHODS: We developed and implemented an image-based simulation pipeline, using intramural recordings from a canine experimental model to define subject-specific ischemic regions within the heart. Static epicardial potential distributions, reflective of ST segment deviations, were simulated and validated against measured epicardial recordings. RESULTS: Simulated epicardial potential distributions showed strong statistical correlation and visual agreement with measured epicardial potentials. Additionally, we identified and described in what way border zone parameters influence epicardial potential distributions during the ST segment. CONCLUSION: From image-based simulations of myocardial ischemia, we generated subject-specific ischemic sources that accurately replicated epicardial potential distributions. Such models are essential in understanding the underlying mechanisms of the bioelectric fields that arise during ischemia and are the basis for more sophisticated simulations of body surface ECGs.

Attentional effects on contrast detection in the presence of surround masks.

We studied how attention affects contrast detection performance when the target is surrounded by mask elements. In each display quadrant we presented a hexagon of six vertical Gabor patches (the 'surround'). Only one of the hexagons contained a central Gabor patch (the 'target') and the task was to report that quadrant (spatial four-alternative-forced choice). Attention was manipulated by means of a double-task paradigm: in one condition observers had to perform concurrently a central letter-discrimination task, and the contrast-detection task was then only poorly attended, while attention was fully available in the other condition. We find that under poorly attended conditions targets can be detected only when the target contrast exceeds the surround contrast (contrast popout) or when the target orientation differs from the surround orientation by more than 10-15 degrees (orientation popout). When the target orientation is similar to the surround orientation, attention can reduce the contrast detection thresholds in some cases more than four-fold, demonstrating a very strong attentional effect.

Performance asymmetries in visual search demonstrate failure of independent-processing models.

We report psychophysical data from orientation-popout experiments that are inconsistent with a rather general decision model. Stimuli consisted of 121 line segments arranged on an 11x11 grid. There were two tasks: in the 1-Singleton Task all lines except one had the same orientation, and observers had to report which quadrant contained the singleton. In the 3-Singleton Task three quadrants contained orientation singletons and observers had to identify the quadrant without singleton. These tasks can be viewed as asymmetric search tasks, in which either a singleton-quadrant has to be found among three homogeneous quadrants, or a homogeneous quadrant has to be found among three singleton-quadrants. Using tools from signal-detection theory we show that the large performance asymmetries between 1-Singleton and 3-Singleton Tasks are inconsistent with any model that makes two (very basic and common) assumptions: (1) independent processing of the four quadrants and (2) an ideal-observer decision. We conclude that at least one of the two assumptions is inadequate. As a plausible reason for the model failure we suggest a global competition between salient elements that reduces popout strength when more than one singleton is present.

Missed targets are more frequent than false alarms: a model for error rates in visual search.

In many visual search tasks, reaction times (RTs) for target detection are measured as a function of display size. The corresponding error rates are usually low but increase with increasing display size. Missed-target errors are more common than false alarms. In recent models of visual search, the error rates were attributed to a premature search termination and error rates increasing with display size were interpreted as indicating a speed-accuracy trade-off and an underestimation of search times per item (obtained from RT slopes). A model is described in which errors occur as a result of imperfect rather than incomplete search (i.e., it is assumed that there are task-specific probabilities of categorizing a target or a distractor incorrectly). Signal-detection theory is used to show that the observed error rate properties can be attributed to an optimized decision strategy. "Corrections" of RT data are thus questionable.

Isolating excitatory and inhibitory nonlinear spatial interactions involved in contrast detection.

Interactions between filters tuned to different orientations and spatial locations were investigated with a masking paradigm. Targets were masked by pairs of Gabor signals presented either at a different orientation (+/- delta theta) or at a different spatial location (+/- delta y). The two mask components were either of equal phase or of opposite phase to each other. Detection thresholds of the target were measured as a function of mask contrast. Typically, the curves obtained showed the following behavior: for increasing mask contrast the threshold first decreased, then reached a minimum and then increased linearly on a log-log scale reflecting a power-law behavior. Mask pairs of equal phase as well as pairs of opposite phase were shown to facilitate detection. Facilitation by mask pairs of equal phase was larger (up to 0.4 log units) and decreased for increasing delta theta and delta y. The facilitation for mask pairs of opposite phase (approximately 0.1 log units) was observed only for larger delta theta and delta y. Phase independent suppression was observed with higher mask contrasts at smaller delta theta and delta y. The strength of this suppression was shown to decrease with practice. We account for the observed facilitation with an accelerating transducer function applied on a second-stage filter. Suppression is modeled with an additional inhibitory second stage filter that divides the output of this transducer. Selective reduction of the inhibitory gain accounts for the practice effects.