A theoretical analysis of acute ischemia and infarction using ECG reconstruction on a 2-D model of myocardium

A. Cimponeriu, C. Frank Starmer, A. Bezerianos

Research output: Contribution to journalArticle

Abstract

We developed a two-dimensional ventricular tissue model in order to probe the determinants of electrocardiographic (ECG) morphology during acute and chronic ischemia. Hyperkalemia was simulated by step changes in K+out, while acidosis was induced by reducing Na+ and Ca2+ conductances. Hypoxia was introduced by its effect on potassium activity. During the initial moments of ischemia, ECG changes were characterized by increases in QRS amplitude and ST segment shortening, followed in the advanced phase by ST baseline elevation, T conformation changes, widening of the QRS and significant decreases in QRS amplitude in spite of an enlarged Q. During each phase, potential proarrhythmic mechanisms were investigated. The presence of unexcitable regions of simulated myocardial infarction led to polymorphic ECG. We also observed a nonuniform deflection of the ST segment from beat to beat. We used similar protocols to explore the responses of infarcted myocardium after impairment resolving. We found that despite irreversible uncoupling of the necrotic region, the restored normal ionic concentrations produced an isopotential ST segment and monomorphic ECG complexes, while an enlarged Q wave was still visible. In summary, these numerical experiments indicate the possibility to track in the ECG pathologic changes following the altered electrophysiology of the ischemic heart.

Original languageEnglish (US)
Pages (from-to)41-54
Number of pages14
JournalIEEE Transactions on Biomedical Engineering
Volume48
Issue number1
DOIs
StatePublished - Jan 1 2001

Keywords

  • Enlarged Q
  • Infarction
  • Ischemia
  • Pointed T
  • Polymorphic ECG
  • QRS amplitude
  • ST deflection
  • Theoretical ECG

ASJC Scopus subject areas

  • Biomedical Engineering

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