Abstract
We present a computationally efficient three-dimensional bidomain model of torso-embedded whole heart electrical activity, with spontaneous initiation of activation in the sinoatrial node, incorporating a specialized conduction system with heterogeneous action potential morphologies throughout the heart. The simplified geometry incorporates the whole heart as a volume source, with heart cavities, lungs, and torso as passive volume conductors. We placed four surface electrodes at the limbs of the torso: V R, V L, V F and V GND and six electrodes on the chest to simulate the Einthoven, Goldberger-augmented and precordial leads of a standard 12-lead system. By placing additional seven electrodes at the appropriate torso positions, we were also able to calculate the vectorcardiogram of the Frank lead system. Themodel was able to simulate realistic electrocardiogram (ECG) morphologies for the 12 standard leads, orthogonal X, Y, and Z leads, as well as the vectorcardiogram under normal and pathological heart states. Thus, simplified and easy replicable 3D cardiac bidomain model offers a compromise between computational load and model complexity and can be used as an investigative tool to adjust cell, tissue, and whole heart properties, such as setting ischemic lesions or regions of myocardial infarction, to readily investigate their effects on whole ECG morphology.
Highlights
Based mathematical models of whole-heart electrical activity are becoming increasingly detailed and complex, with high-resolution anatomically accurate models requiring extensive computation times, dedicated software, and even the use of supercomputers [1,2,3]
We have developed a simplified 3D model of the torsoembedded whole heart capable of generating spontaneous and morphologically realistic 12-lead ECG signals at the torso surface, offering a good compromise between computational efficiency, model complexity, and simulated ECG signal quality
Two cases were simulated in which myocardial infarctions were imposed at different heart regions, and the impact on ECG morphology was observed
Summary
Based mathematical models of whole-heart electrical activity are becoming increasingly detailed and complex, with high-resolution anatomically accurate models requiring extensive computation times, dedicated software, and even the use of supercomputers [1,2,3]. This simplified whole heart model can be utilized as a starting point for the rapid a priori formulation, testing, and refinement of hypothesis on the forward and inverse relations between the surface ECG and cardiac cell or tissue properties, including action potential duration, refractory period, upstroke velocity, amplitude, conduction velocity, and tissue conductivity in various subregions of the heart This will allow the ready visualization of the relation between specific myocardial electrical properties and the resulting body surface potentials, expressed as a standard 12-lead ECG system, a vectorcardiogram (VCG), an electrogram (EGM), a body surface potential map (BSPM), or any other lead system. Such a model could readily be utilized to simulate regions of the heart with reduced excitability and/or conduction disturbance, for the development of new diagnostic tools able to inversely assess key cardiac properties or localization of ischemic or infarcted regions by processing features of the ECG
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