title: Impact of mechanical deformation on pseudo-ECG: a simulation study.
abstract: OBJECTIVE
  Electrophysiological simulations may help to investigate causes and possible treatments of ventricular conduction disturbances. Most electrophysiological models do not take into account that the heart moves during the cardiac cycle. We used an electro-mechanical model to study the effect of mechanical deformation on the results of electrophysiological simulations.
  
  
  RESULTS
  Pseudo-electrocardiogram (ECG) were generated from the propagation of electrical signals in tissue slabs undergoing active mechanical deformation. We used the mono-domain equation for electrophysiology with the Bueno-Orovio ionic model and a fully incompressible Guccione-Costa hyperelastic law for the mechanics with the Nash-Panfilov model for the active force. We compared a purely electrophysiological approach (PE) with mono-directional (MD) and bi-directional (BD) electromechanical coupling strategies. The numerical experiments showed that BD and PE simulations led to different S- and T-waves. Mono-directional simulations generally approximated the BD ones, unless fibres were oriented along one short axis of the slab. When present, notching in the QRS-complex was larger in MD than in BD simulations.
  
  
  CONCLUSIONS
  Tissue deformation has to be taken into account when estimating the S- and T-wave of the ECG in electrophysiological simulations.
authors.affiliation: Center for Computational Medicine in Cardiology, Institute of Computational Science, Università della Svizzera Italiana, Via Giuseppe Buffi 13, Lugano CH-6900, Switzerland; marco.favino@usi.ch.
authors.forename: Marco
authors.initials: M
authors.lastname: Favino
authors.affiliation: Center for Computational Medicine in Cardiology, Institute of Computational Science, Università della Svizzera Italiana, Via Giuseppe Buffi 13, Lugano CH-6900, Switzerland.
authors.forename: Sonia
authors.initials: S
authors.lastname: Pozzi
authors.affiliation: Center for Computational Medicine in Cardiology, Institute of Computational Science, Università della Svizzera Italiana, Via Giuseppe Buffi 13, Lugano CH-6900, Switzerland.
authors.forename: Simone
authors.initials: S
authors.lastname: Pezzuto
authors.affiliation: Department of Physiology, Cardiovascular Research Institute Maastricht (CARIM), Universiteitssingel 50, 6229 ER Maastricht, The Netherlands.
authors.forename: Frits W
authors.initials: FW
authors.lastname: Prinzen
authors.affiliation: Center for Computational Medicine in Cardiology, Institute of Computational Science, Università della Svizzera Italiana, Via Giuseppe Buffi 13, Lugano CH-6900, Switzerland.|Division of Cardiology, Fondazione Cardiocentro Ticino, Via Tesserete 48, 6900 Lugano, Switzerland.
authors.forename: Angelo
authors.initials: A
authors.lastname: Auricchio
authors.affiliation: Center for Computational Medicine in Cardiology, Institute of Computational Science, Università della Svizzera Italiana, Via Giuseppe Buffi 13, Lugano CH-6900, Switzerland.
authors.forename: Rolf
authors.initials: R
authors.lastname: Krause
mesh_terms: D000200:Action Potentials; D003198:Computer Simulation; D004562:Electrocardiography; D006329:Heart Conduction System / Q000502:physiology*; D006339:Heart Rate; D006801:Humans; D008955:Models, Cardiovascular; D009200:Myocardial Contraction; D009716:Numerical Analysis, Computer-Assisted; D011237:Predictive Value of Tests; D012815:Signal Processing, Computer-Assisted; D013997:Time Factors
keywords: Electro-mechanical computational model; Notching in QRS-complex; Pseudo-ECG; T-wave morphology