Computer simulation of propagated activation in different types of left ventricular enlargement

An increase of the left ventricular mass does not always have an unambiguous effect on the electro- or vectorcardiographic image of ventricular activation. To analyse this phenomenon, three types of left ventricular enlargement were simulated by a computer model of propagated activation in cardiac ventricles. These were obtained from the reference (normal) left ventricle by an increase of its wall thickness either centripetally or centrifugally, as well as by increase of the ventricular cavity dimensions (dilatation). Two different degrees of mentioned changes, corresponding to an increase of the value of the respective parameters by 50% or 100% of reference left ventricular wall thickness, were analysed. In the case of a centrifugal increase of left ventricular wall thickness, the magnitude of instantaneous cardiac vectors increased only during the last two-thirds of ventricular activation time. A centripetal increase of the wall thickness resulted in a decrease of the resultant cardiac vector magnitudes during the first half of ventricular activation followed by their slight increase. In dilatation of the left ventricle the cardiac vectors were enhanced during the whole activation time.