CARDONE-NOOTT, Louie; BUENO-OROVIO, Alfonso; MINCHOLÉ, Ana; ZEMZEMI, Nejib; RODRIGUEZ, Blanca

doi:10.1093/europace/euw346

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CARDONE-NOOTT, Louie
Computing Science Laboratory - Oxford University

BUENO-OROVIO, Alfonso
Computing Science Laboratory - Oxford University

MINCHOLÉ, Ana
Computing Science Laboratory - Oxford University

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EP-Europace. 2016-12-23

Oxford University Press (OUP)

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Multiscale bidomain simulations using a detailed heart-torso human anatomical model are performed to investigatethe impact of activation sequence characteristics on clinical QRS biomarkers. Activation sequences are built andvalidated against experimentally-derived ex vivo and in vivo human activation data. R-peak amplitude exhibits thelargest variability in terms of QRS morphology, due to its simultaneous modulation by activation sequence speed,myocardial intracellular and extracellular conductivities, and propagation through the human torso. QRS width,however, is regulated by endocardial activation speed and intracellular myocardial conductivities, whereas QRintervals are only affected by the endocardial activation profile. Variability in the apico-basal location of activationsites on the anterior and posterior left ventricular wall is associated with S-wave progression in limb and precordialleads, respectively, and occasional notched QRS complexes in precordial derivations. Variability in the number ofearly activation sites successfully reproduces pathological abnormalities of the human conduction system in theQRS complex.< Réduire

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Human ventricular activation sequence and the simulation of the electrocardiographic QRS complex and its variability in healthy and intraventricular block conditions

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