Human ventricular activation sequence and the simulation of the electrocardiographic QRS complex and its variability in healthy and intraventricular block conditions
Résumé
Multiscale bidomain simulations using a detailed heart-torso human anatomical model are performed to investigate
the impact of activation sequence characteristics on clinical QRS biomarkers. Activation sequences are built and
validated against experimentally-derived ex vivo and in vivo human activation data. R-peak amplitude exhibits the
largest variability in terms of QRS morphology, due to its simultaneous modulation by activation sequence speed,
myocardial intracellular and extracellular conductivities, and propagation through the human torso. QRS width,
however, is regulated by endocardial activation speed and intracellular myocardial conductivities, whereas QR
intervals are only affected by the endocardial activation profile. Variability in the apico-basal location of activation
sites on the anterior and posterior left ventricular wall is associated with S-wave progression in limb and precordial
leads, respectively, and occasional notched QRS complexes in precordial derivations. Variability in the number of
early activation sites successfully reproduces pathological abnormalities of the human conduction system in the
QRS complex.
Domaines
Modélisation et simulation
Origine : Fichiers produits par l'(les) auteur(s)
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