Boonstra, Machteld J;
Oostendorp, Thom F;
Roudijk, Rob W;
Kloosterman, Manon;
Asselbergs, Folkert W;
Loh, Peter;
Van Dam, Peter M;
(2022)
Incorporating structural abnormalities in equivalent dipole layer based ECG simulations.
Frontiers in Physiology
, 13
, Article 1089343. 10.3389/fphys.2022.1089343.
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Abstract
Introduction: Electrical activity of the myocardium is recorded with the 12-lead ECG. ECG simulations can improve our understanding of the relation between abnormal ventricular activation in diseased myocardium and body surface potentials (BSP). However, in equivalent dipole layer (EDL)-based ECG simulations, the presence of diseased myocardium breaks the equivalence of the dipole layer. To simulate diseased myocardium, patches with altered electrophysiological characteristics were incorporated within the model. The relation between diseased myocardium and corresponding BSP was investigated in a simulation study. Methods: Activation sequences in normal and diseased myocardium were simulated and corresponding 64-lead BSP were computed in four models with distinct patch locations. QRS-complexes were compared using correlation coefficient (CC). The effect of different types of patch activation was assessed. Of one patient, simulated electrograms were compared to electrograms recorded during invasive electro-anatomical mapping. Results: Hundred-fifty-three abnormal activation sequences were simulated. Median QRS-CC of delayed versus dyssynchronous were significantly different (1.00 vs. 0.97, p < 0.001). Depending on the location of the patch, BSP leads were affected differently. Within diseased regions, fragmentation, low bipolar voltages and late potentials were observed in both recorded and simulated electrograms. Discussion: A novel method to simulate cardiomyopathy in EDL-based ECG simulations was established and evaluated. The new patch-based approach created a realistic relation between ECG waveforms and underlying activation sequences. Findings in the simulated cases were in agreement with clinical observations. With this method, our understanding of disease progression in cardiomyopathies may be further improved and used in advanced inverse ECG procedures.
| Type: | Article |
|---|---|
| Title: | Incorporating structural abnormalities in equivalent dipole layer based ECG simulations |
| Location: | Switzerland |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.3389/fphys.2022.1089343 |
| Publisher version: | https://doi.org/10.3389/fphys.2022.1089343 |
| Language: | English |
| Additional information: | Copyright © 2022 Boonstra, Oostendorp, Roudijk, Kloosterman, Asselbergs, Loh and Van Dam. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Physiology, electrocardiogram (ECG), equivalent dipole layer, ECGsim, myocardial disease, cardiac activation, simulation, HEART-ASSOCIATION ELECTROCARDIOGRAPHY, OF-CARDIOLOGY-FOUNDATION, RIGHT-VENTRICULAR CARDIOMYOPATHY/DYSPLASIA, ARRHYTHMIAS COMMITTEE, SCIENTIFIC STATEMENT, CLINICAL CARDIOLOGY, AHA/ACCF/HRS RECOMMENDATIONS, INTERACTIVE SIMULATION, TORSO INHOMOGENEITIES, RHYTHM-SOCIETY |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics > Clinical Epidemiology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10164911 |
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