Human ventricular activation sequence and the simulation of the electrocardiographic QRS complex and its variability in healthy and intraventricular block conditions
Cardone-Noott, Louie ; Bueno-Orovio, Alfonso ; Mincholé, Ana ; Zemzemi, Nejib ; Rodríguez, Blanca
Resumen: Aims
To investigate how variability in activation sequence and passive conduction properties translates into clinical variability in QRS biomarkers, and gain novel physiological knowledge on the information contained in the human QRS complex.
Methods and results
Multiscale bidomain simulations using a detailed heart-torso human anatomical model are performed to investigatethe 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 ofearly activation sites successfully reproduces pathological abnormalities of the human conduction system in the QRS complex.
Conclusion
Variability in activation sequence and passive conduction properties captures and explains a large part of the clinical variability observed in the human QRS complex. Our physiological insights allow for a deeper interpretation of human QRS biomarkers in terms of QRS morphology and location of early endocardial activation sites. This mightbe used to attain a better patient-specific knowledge of activation sequence from routine body-surface electrocardiograms.
Idioma: Inglés
DOI: 10.1093/europace/euw346
Año: 2016
Publicado en: Europace 18, Suppl 4 (2016), iv4 - iv15
ISSN: 1099-5129
Factor impacto JCR: 4.53 (2016)
Categ. JCR: CARDIAC & CARDIOVASCULAR SYSTEMS rank: 31 / 126 = 0.246 (2016) - Q1 - T1
Factor impacto SCIMAGO: 2.673 - Physiology (medical) (Q1) - Cardiology and Cardiovascular Medicine (Q1)
Tipo y forma: Artículo (Versión definitiva)
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Exportado de SIDERAL (2024-09-12-13:15:36)
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To investigate how variability in activation sequence and passive conduction properties translates into clinical variability in QRS biomarkers, and gain novel physiological knowledge on the information contained in the human QRS complex.
Methods and results
Multiscale bidomain simulations using a detailed heart-torso human anatomical model are performed to investigatethe 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 ofearly activation sites successfully reproduces pathological abnormalities of the human conduction system in the QRS complex.
Conclusion
Variability in activation sequence and passive conduction properties captures and explains a large part of the clinical variability observed in the human QRS complex. Our physiological insights allow for a deeper interpretation of human QRS biomarkers in terms of QRS morphology and location of early endocardial activation sites. This mightbe used to attain a better patient-specific knowledge of activation sequence from routine body-surface electrocardiograms.
Idioma: Inglés
DOI: 10.1093/europace/euw346
Año: 2016
Publicado en: Europace 18, Suppl 4 (2016), iv4 - iv15
ISSN: 1099-5129
Factor impacto JCR: 4.53 (2016)
Categ. JCR: CARDIAC & CARDIOVASCULAR SYSTEMS rank: 31 / 126 = 0.246 (2016) - Q1 - T1
Factor impacto SCIMAGO: 2.673 - Physiology (medical) (Q1) - Cardiology and Cardiovascular Medicine (Q1)
Tipo y forma: Artículo (Versión definitiva)
Debe reconocer adecuadamente la autoría, proporcionar un enlace a la licencia e indicar si se han realizado cambios. Puede hacerlo de cualquier manera razonable, pero no de una manera que sugiera que tiene el apoyo del licenciador o lo recibe por el uso que hace. Exportado de SIDERAL (2024-09-12-13:15:36)
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Registro creado el 2021-02-26, última modificación el 2024-09-12