Document Detail

Cardiac position sensitivity study in the electrocardiographic forward problem using stochastic collocation and boundary element methods.
MedLine Citation:
PMID:  21909818     Owner:  NLM     Status:  MEDLINE    
The electrocardiogram (ECG) is ubiquitously employed as a diagnostic and monitoring tool for patients experiencing cardiac distress and/or disease. It is widely known that changes in heart position resulting from, for example, posture of the patient (sitting, standing, lying) and respiration significantly affect the body-surface potentials; however, few studies have quantitatively and systematically evaluated the effects of heart displacement on the ECG. The goal of this study was to evaluate the impact of positional changes of the heart on the ECG in the specific clinical setting of myocardial ischemia. To carry out the necessary comprehensive sensitivity analysis, we applied a relatively novel and highly efficient statistical approach, the generalized polynomial chaos-stochastic collocation method, to a boundary element formulation of the electrocardiographic forward problem, and we drove these simulations with measured epicardial potentials from whole-heart experiments. Results of the analysis identified regions on the body-surface where the potentials were especially sensitive to realistic heart motion. The standard deviation (STD) of ST-segment voltage changes caused by the apex of a normal heart, swinging forward and backward or side-to-side was approximately 0.2 mV. Variations were even larger, 0.3 mV, for a heart exhibiting elevated ischemic potentials. These variations could be large enough to mask or to mimic signs of ischemia in the ECG. Our results suggest possible modifications to ECG protocols that could reduce the diagnostic error related to postural changes in patients possibly suffering from myocardial ischemia.
Darrell J Swenson; Sarah E Geneser; Jeroen G Stinstra; Robert M Kirby; Rob S MacLeod
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.     Date:  2011-09-10
Journal Detail:
Title:  Annals of biomedical engineering     Volume:  39     ISSN:  1573-9686     ISO Abbreviation:  Ann Biomed Eng     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-11-03     Completed Date:  2012-03-06     Revised Date:  2013-06-27    
Medline Journal Info:
Nlm Unique ID:  0361512     Medline TA:  Ann Biomed Eng     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2900-10     Citation Subset:  IM    
Department of Bioengineering, University of Utah, Salt Lake City, UT, USA.
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MeSH Terms
Computer Simulation
Electrocardiography / methods*
Finite Element Analysis*
Heart / physiology*
Myocardial Ischemia / diagnosis
Posture / physiology
Sensitivity and Specificity
Stochastic Processes
Grant Support
P41 GM103545/GM/NIGMS NIH HHS; P41 RR012553/RR/NCRR NIH HHS; P41 RR012553-09/RR/NCRR NIH HHS; P41-RR12553-12/RR/NCRR NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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