The effect of nontransmural necroses on epicardial potential maps during paced activation: a simulation study

A number of studies have indicated that epicardial potentials provide detailed spatiotemporal information about the spread of electrical activation within the ventricular wall. Here, we used a computer model to simulate activation sequences and corresponding epicardial potential maps in the ventricles damaged by localized necroses. Our findings agreed with those of experimental studies performed for epicardial pacing locus in a complete transient loss of one of the positive areas when the necrosis was located subepicardially, and in a transient gap in the expanding positive areas when the necrosis was located intramurally and subendocardially. This study--by systematically comparing simulated epicardial potential maps with those recorded on the exposed canine hearts--constitutes an important step in validation of our model.