Journal
JOURNAL OF ELECTROCARDIOLOGY
Volume 48, Issue 4, Pages 617-625Publisher
CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS
DOI: 10.1016/j.jelectrocard.2015.05.004
Keywords
Geometry; ECG morphology; VCG; Computer simulation
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Funding
- Swiss National Supercomputing Centre (CSCS) [397]
- Fondazione Cardiocentro Ticino
- Theo Rossi di Montelera Foundation
- Mantegazza Foundation
- FIDINAM
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Aim: The aim of this study was to investigate the influence of geometrical factors on the ECG morphology and vectorcardiogram (VCG) parameters. Methods: Patient-tailored models based on five heart-failure patients with intraventricular conduction defects (IVCDs) were created. The heart was shifted up to 6 cm to the left, right, up, and down and rotated +/- 30 degrees around the anteroposterior axis. Precordial electrodes were shifted 3 cm down. Results: Geometry modifications strongly altered ECG notching/slurring and intrinsicoid deflection time. Maximum VCG parameter changes were small for QRS duration (-6% to +10%) and QRS-T angle (-6% to +3%), but considerable for QRS amplitude (-36% to +59%), QRS area (-37% to +42%), T-wave amplitude (-41% to +36%), and T-wave area (-42% to +33%). Conclusion: The position of the heart with respect to the electrodes is an important factor determining notching/slurring and voltage-dependent parameters and therefore must be considered for accurate diagnosis of IVCDs. (C) Elsevier Inc. All rights reserved.
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