On modeling the Wilson terminal in the boundary and finite element method

In clinical electrocardiography, the zero-potential is commonly defined by the Wilson central terminal. In the electrocardiographic forward and inverse problem, the zero-potential is often defined in a different way, e.g., by the sum of all node potentials yielding zero. This study presents relatively simple to implement techniques, which enable the incorporation of the Wilson Terminal in the boundary element method (BEM) and finite element method (FEM). For the BEM, good results are obtained when properly adopting matrix deflation for modeling the Wilson terminal. Applying other zero-potential-definitions, the obtained solutions contained a remarkable offset with respect to the reference defined by the Wilson terminal. In the inverse problem (nonlinear dipole fit), errors introduced by an erroneous zero-potential-definition can lead to displacements of more than 5 mm in the computed dipole location. For the FEM, a method similar to matrix deflation is proposed in order to properly consider the Wilson central terminal. The matrix obtained from this manipulation is symmetric, sparse and positive definite enabling the application of standard FEM-solvers.