Modeling Structural Abnormalities in Equivalent Dipole Layer Based ECG Simulations

The relation between abnormal ventricular activation and corresponding ECGs still requires additional understanding. The presence of disease breaks the equivalence in equivalent dipole layer-based ECG simulations. In this study, endocardial and epicardial patches were introduced to simulate abnormal wave propagation in different types of substrates. The effect of these different types of substrates on the QRS complex was assessed using a boundary element method forward heart/torso and a 64-lead body surface potential map (BSPM). Activation was simulated using the fastest route algorithm with six endocardial foci and QRS complexes corresponding to abnormal patch activation were compared to the QRS complexes of normal ventricular activation using correlation coefficient (CC). Abnormal patch activation affected both QRS morphology and duration. These QRS changes were observed in different leads, depending on substrate location. With insights obtained in such simulations, risk-stratification and understanding of disease progression may be further enhanced.