The study of the influence of heart ventricular wall thickness on pseudo-ECG

Abstract

Abstract Electrocardiogram is a widespread method of diagnosis of heart diseases. Nevertheless, there are still issues related to connection of some physiological features of themyocardium with patterns observed on the electrocardiogram. In ourworkwe studied the effect of ventricular remodelling, i.e., thickening ofwalls of ventricles typical for hypertrophic cardiomyopathy (HCM), on the pseudo-electrocardiogram on the surface of a volume conductor during myocardial activation from different sources. A model of two ventricles of the heart was developed for this purpose allowing us to vary ventricular geometry. The volume conductor surrounding the heart was a cubic homogeneous volume conductor. Simulation of a pseudo-electrocardiogram was performed by using a realistic ionic model of cardiomyocytes of the ventricles of the human heart and the bidomain model of the myocardium [15]. The zone of initial activation in the model was given on a part of the subendocardial surface or at one or two points corresponding to positions of electrodes of most common implantable devices. In the course of the study we revealed an inversion of the T-wave when changing the thickness of the left ventricle wall regardless of changes of properties of cardiomyocytes or myocardium conductivity. A linear dependence between the wall thickness of the left ventricle and peak amplitudes and integrals under QRS complex and T wave of the electrocardiogram was shown. We have qualitatively shown that with a change in the wall thickness of the left ventricle the pseudo-electrocardiogram changes stronger in the case of activation from one point than in activation from two points or activation of the entire subendocardium.