Inverse estimation of ventricular Purkinje tree pathways from sequences of depolarization

The electrical activation of the heart is a complex process that is essential for the understanding and treatment of several cardiac dysfunctions, such as ventricular tachycardia. Patient-specific local activation times (LAT) are usually obtained using electro-anatomical maps, however unveiling the underlying fast pathways formed by the Purkinje network remains a complex problem. We present a method based on differential geometry to estimate from a set of endocardium LATs, the locations on the endocardium with a potential number of Purkinje myocardial junctions, and the corresponding Purkinje branching structure. We evaluate our method on biophysical simulations using several Purkinje configurations. LAT errors of estimated Purkinje trees are in the order of 6 ms.