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Changes in body-surface electrocardiograms from geometric remodeling with obesity
R Martin Arthur1, Shuli Wang, Jason W Trobaugh
1Department of Electrical and Systems Engineering, Washington University School of Engineering, St. Louis, MO 63130, USA. rma@ese.wustl.edu
IEEE Transactions on Bio-Medical Engineering
|January 11, 2011
Summary
Obesity significantly alters body shape, impacting electrocardiograms (ECGs). Standard ECG leads are insufficient for obese individuals, necessitating advanced methods like body-surface mapping for accurate cardiac assessment.
Area of Science:
- Cardiology
- Biomedical Engineering
- Medical Imaging
Background:
- Obesity and diabetes are linked to cardiac dysfunction.
- Geometric changes in obesity can affect electrocardiograms (ECGs).
- Distinguishing geometric from electrophysiological cardiac changes is crucial.
Purpose of the Study:
- To investigate how cardiac and torso geometric changes in obesity influence body-surface ECGs.
- To quantify the impact of obesity-related anatomical alterations on ECG measurements.
- To assess the limitations of standard ECG lead sets in obese individuals.
Main Methods:
- Utilized the ECGSIM simulation package with modified realistic heart and torso models.
- Calculated body-surface ECGs from cardiac action potentials using a bidomain forward-problem solution.
- Analyzed ECGs with spectral analysis, principal-component analysis, and isopotential/energy maps.
Main Results:
- Obesity-related geometric changes caused significant relative errors in ECGs during the QT interval (up to 68% for heart displacement).
- Heart displacement due to obesity led to a substantial mean relative error of 78% in precordial leads.
- Standard 12-lead ECG sets showed major limitations in characterizing ECG changes in obese subjects.
Conclusions:
- Standard ECG lead sets are inadequate for characterizing cardiac electrical activity in obese individuals.
- Body-surface mapping and inverse electrocardiography are recommended for accurate assessment of electrical remodeling in obesity.
- Further research is needed to develop inclusive ECG measures for individuals with altered body habitus.
