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Updated: Aug 14, 2025

Patient-specific Modeling of the Heart: Estimation of Ventricular Fiber Orientations

Patient-specific Modeling of the Heart: Estimation of Ventricular Fiber Orientations

Published on: January 8, 2013

Incorporating structural abnormalities in equivalent dipole layer based ECG simulations.

Machteld J Boonstra¹, Thom F Oostendorp², Rob W Roudijk¹

¹Department of Cardiology, Division Heart and Lungs, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.

Frontiers in Physiology

|January 9, 2023

Summary

This summary is machine-generated.

This study introduces a new patch-based method for simulating diseased myocardium in electrocardiogram (ECG) models. This approach realistically links ECG waveforms to abnormal heart activation, improving our understanding of cardiomyopathies.

Keywords:

ECGsim cardiac activation electrocardiogram (ECG)equivalent dipole layer myocardial disease simulation

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Last Updated: Aug 14, 2025

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Area of Science:

Cardiology
Biomedical Engineering
Computational Electrophysiology

Background:

The 12-lead electrocardiogram (ECG) records myocardial electrical activity.
ECG simulations aid in understanding the link between diseased myocardium and body surface potentials (BSP).
Existing equivalent dipole layer (EDL)-based simulations face challenges with diseased myocardium disrupting dipole layer equivalence.

Purpose of the Study:

To develop and evaluate a novel patch-based method for simulating diseased myocardium in EDL-based ECG models.
To investigate the relationship between diseased myocardial regions and corresponding BSP.
To assess the impact of altered electrophysiological characteristics on ECG simulations.

Main Methods:

Simulated activation sequences in normal and diseased myocardium.
Computed 64-lead BSP in four models with distinct diseased patch locations.
Compared QRS-complexes using correlation coefficient (CC) and assessed patch activation effects.
Validated simulated electrograms against patient-recorded invasive electro-anatomical mapping data.

Main Results:

Successfully simulated 153 abnormal activation sequences.
Demonstrated significant differences in QRS-CC between delayed and dyssynchronous activation (median 1.00 vs. 0.97, p < 0.001).
Observed distinct BSP lead alterations based on patch location.
Identified fragmentation, low bipolar voltages, and late potentials in simulated and recorded electrograms within diseased regions.

Conclusions:

Established a novel, patch-based method for simulating cardiomyopathy in EDL-based ECG simulations.
The patch-based approach realistically connects ECG waveforms with underlying activation sequences.
Simulated findings align with clinical observations, suggesting potential for improved understanding and advanced inverse ECG procedures for cardiomyopathies.