Computer based modeling of the congenital long-QT 2 syndrome in the Visible Man torso: From genes to ECG

Abstract

The congenital long-QT syndrome is commonly associated with a high risk for polymorphic ventricular tachy-cardia and sudden cardiac death. This is probably due to an intensification of the intrinsic heterogeneities present in ventricular myocardium. Increasing the electrophysiological heterogeneities amplifies the dispersion of repolarization which directly affects the morphology of the T wave in the ECG. The aim of this work is to investigate the effects of LQT2, a specific subtype of the long-QT syndrome (LQTS), on the Body Surface Potential Maps (BSPM) and the ECG. In this context a three-dimensional, heterogeneous model of the human ventricles is used to simulate both physiological and pathological excitation propagation. The results are used as input for the forward calculation of the BSPM and ECG. Characteristic QT prolongation is simulated correctly. The main goal of this study is to prepare and evaluate a simulation environment that can be used prospectivley to find features in the ECG or the BSPM that are characteristic for the LQTS. Such features might be used to facilitate the identification of LQTS patients.

Mathematical Modeling of Electrocardiograms: A Numerical Study

“…As a result, as also noticed in Boulakia et al, 5 Keller et al, 30 and Potse et al, 40,41 transmural APD heterogeneity is a major ingredient in the simulation of a complete 12-lead ECG with physiological T-wave polarities.…”

“…Conrath and Opthof, 13 for a review), experimental evidence 2,20,27,59 suggests that transmural APD heterogeneity is likely to be the most important factor in the genesis of the normal ECG T-wave shape and polarity. A number of simulation studies 5,14,30,40,41 confirm also this (still debated) postulate. Interestingly, the numerical investigations recently reported in Colli Franzone et al 11 (using a highly idealized geometry) indicate that the polarity of the T-wave (for unipolar ECG leads) may be mainly driven by the cardiac tissue anisotropy.…”

“…the monographs 44,47,51 and the references therein), only a small number 28,30,32,41,43,54 addresses the numerical simulation of ECGs using a whole-heart reaction-diffusion (i.e. bidomain or monodomain) model.…”

Electrophysiological Modeling for Cardiology: Methods and Potential Applications

“…The monodomain equations and the heterogeneous ten Tusscher et al cell model [14] were considered. LQT2 was incorporated into this model by reducing the maximum conductance g Kr,max of I Kr .…”

Three-dimensional Multiscale Modelling and Simulation of Atria and Torso Electrophysiology

“…However, other studies carried out by (Lines et al 2003;Potse et al 2003;Trudel et al 2004;Keller et al 2007;Potse et al 2009) already considered the bidomain or monodomain approaches, although only (Potse et al 2003;Potse et al 2009) provided the final simulations of the standard ECG leads.…”