Key result
Simulated ECG signals and body surface potentials during premature ventricular contractions best matched real patient measurements when the stimulated region was <10 mm from the initial ectopic site.
Why the study?
The study was designed to simulate electrical activation of the ventricles and corresponding body surface potentials during premature ventricular contractions using a patient-specific realistic model of the ventricles and torso.
Patient-specific bidomain ventricular modeling can accurately simulate ECG and body surface potentials of PVCs, closely matching clinical measurements when the simulated origin is within 10 mm of the true ectopic focus.
Supports model refinement for PVC simulation; animal data leave open clinical translation to ablation guidance.
The goal of the study was to simulate electrical activation of the heart ventricles and corresponding body surface potentials (BSPs) during premature ventricular contractions (PVC) using the patient specific realistic homogeneous model of cardiac ventricles and the torso. Real position of the initial ectopic activation during PVC was determined by intracardial measurement in the upper part of the right ventricle near the His bundle and confirmed by successful catheter ablation of the PVC origin. Simulated electrical activation in the ventricular model was started at the position of the initial ectopic activation as well as at several other sites at various distances from this position. The propagation of electrical activation in the ventricular model was modeled using bidomain reaction-diffusion (RD) equations with the ionic transmembrane current density defined by the modified FitzHugh-Nagumo (FHN) equations. The torso was modeled as a homogeneous passive volume conductor. The RD equations were numerically solved in the Comsol Multiphysics environment. Simulated ECG signals and BSPs were compared with those measured during PVC in a real patient. The polarity and shape of simulated and measured ECG leads as well as the BSP distribution during the PVC were in best agreement when the stimulated region was less than 10 mm from the position of the initial ectopic activation.
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Cocherová et al. (2023) studied Premature ventricular contractions (PVC) (n=1). Patient-specific bidomain ventricular model simulation vs. Measured ECG signals and BSPs from the real patient was evaluated on Agreement between simulated and measured ECG leads and BSP distribution. Simulated ECG signals and body surface potentials during premature ventricular contractions best matched real patient measurements when the stimulated region was <10 mm from the initial ectopic site.
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