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Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Physiol. | doi: 10.3389/fphys.2019.01103

MRI-based computational torso/biventricular multiscale models to investigate the impact of anatomical variability on the ECG QRS complex

  • 1Department of Computer Science, Mathematical, Physical and Life Sciences Division, University of Oxford, United Kingdom
  • 2Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, United Kingdom
  • 3Radcliffe Department of Medicine, University of Oxford, United Kingdom

Aims: Patient-to-patient anatomical differences are an important source of variability in the electrocardiogram, and they may compromise the identification of pathological electrophysiological abnormalities. This study aims at quantifying the contribution of variability in ventricular and torso anatomies to differences in QRS complexes of the 12-lead ECG using computer simulations.
Methods: A computational pipeline is presented that enables computer simulations using human torso/biventricular anatomically-based electrophysiological models from clinically standard magnetic resonance imaging (MRI). The ventricular model includes membrane kinetics represented by the biophysically-detailed O’Hara Rudy model modified for tissue heterogeneity and includes fibre orientation based on the Streeter rule. A population of 265 torso/biventricular models was generated by combining ventricular and torso anatomies obtained from clinically standard MRIs, augmented with a statistical shape model of the body. 12-lead ECGs were simulated on the 265 human torso/biventricular electrophysiology models, and QRS morphology, duration and amplitude were quantified in each ECG lead for each of the human torso-biventricular models.
Results: QRS morphologies in limb leads are mainly determined by ventricular anatomy, while in the precordial leads, and especially V1 to V4, they are determined by heart position within the torso. Differences in ventricular orientation within the torso can explain morphological variability from monophasic to biphasic QRS complexes. QRS duration is mainly influenced by myocardial volume, while it is hardly affected by the torso anatomy or position. An average increase of 0.12±0.05ms in QRS duration is obtained for each cm3 of myocardial volume across all the leads while it hardly changed due to changes in torso volume.
Conclusion: Computer simulations using populations of human torso/biventricular models based on clinical MRI enable quantification of anatomical causes of variability in the QRS complex of the 12-lead ECG. The human models presented also pave the way towards their use as testbeds in silico clinical trials.

Keywords: computer simulations, electrocardiogram, Computational modelling, cardiac magnetic resonance imaging, Clinical MRI-based torso/ventricular anatomical models

Received: 08 Mar 2019; Accepted: 08 Aug 2019.

Copyright: © 2019 Minchole, Zacur, Ariga, Grau and Rodriguez. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: PhD. Ana Minchole, Department of Computer Science, Mathematical, Physical and Life Sciences Division, University of Oxford, Oxford, OX1 3QD, England, United Kingdom, ana.minchole@cs.ox.ac.uk