Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Dec 13:14:1295103.
doi: 10.3389/fphys.2023.1295103. eCollection 2023.

Basis and applicability of noninvasive inverse electrocardiography: a comparison between cardiac source models

Jeanne van der Waal  1 , Veronique Meijborg  1 , Ruben Coronel  1 , Rémi Dubois #  2 , Thom Oostendorp #  3
Affiliations
Review

Basis and applicability of noninvasive inverse electrocardiography: a comparison between cardiac source models

Jeanne van der Waal et al. Front Physiol. .

Abstract

The body surface electrocardiogram (ECG) is a direct result of electrical activity generated by the myocardium. Using the body surface ECGs to reconstruct cardiac electrical activity is called the inverse problem of electrocardiography. The method to solve the inverse problem depends on the chosen cardiac source model to describe cardiac electrical activity. In this paper, we describe the theoretical basis of two inverse methods based on the most commonly used cardiac source models: the epicardial potential model and the equivalent dipole layer model. We discuss similarities and differences in applicability, strengths and weaknesses and sketch a road towards improved inverse solutions by targeted use, sequential application or a combination of the two methods.

Keywords: ECGI; cardiac source models; electrocardiographic imaging; electrocardiography; inverse electrocardiography; noninvasive mapping.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Figures

FIGURE 1
FIGURE 1
Transversal cross section of a volume conductor model of the thorax, showing lungs and ventricles. The red line indicates the location of the epicardial potential (EP) source (in this example limited to the ventricles): a closed surface that contains all electric sources within the ventricular myocardium. In the volume conductor model for the EP-based inverse method the source surface is considered as an internal boundary of the volume conductor; all tissue within that surface is ignored. The transfer matrix describes the relation between the electrograms (EGM) at the epicardial surface (j) and the electrocardiogram (ECG) at the body surface (i).
FIGURE 2
FIGURE 2
Transversal cross section of a volume conductor model of the thorax, showing lungs and ventricles, and intraventricular blood mass. The dark blue line indicates the location of the equivalent dipole layer source (in this example limited to the ventricles): the surface of the myocardial tissue. Notice that this includes both epicardium and endocardium. The transfer matrix describes the relation between the transmembrane potential (TMP) at the endo-/epicardial surface (j) and the electrocardiogram (ECG) at the body surface (i).
FIGURE 3
FIGURE 3
(A) Template for transmembrane potential (TMP) (see Supplementary Material). (B) This template is shifted and stretched to match the activation and repolarization times (AT and RT) of the nodes at the myocardial surface (example for two nodes are plotted).
FIGURE 4
FIGURE 4
Lead V2 sensitivity maps: maps of the sensitivity of electrode V2 to source activity at the heart surface [see Van Oosterom and Huiskamp (1989) for details]. Top row: EP sensitivity map for the EP method; source activity is defined as a region of 1 cm2 that impresses 15 mV at the location considered, and zero elsewhere. Bottom row: sensitivity map for the EDL method; source activity is defined as a completely depolarized 1 cm2 region at the location considered, and complete polarization elsewhere. For the EP method, the strongest sensitivity for the epicardium is 0.57 mV/cm2 (at the location closest to V2), whereas the strongest sensitivity for the endocardium is -0.0019 mV/cm2. For the EDL methods, these values are -0.56 mV/cm2 and 0.43 mV/cm2 respectively. This shows that the EP-based inverse, in contrast to the EDL-based inverse, is completely insensitive to the endocardium.
See this image and copyright information in PMC

References

    1. Bacoyannis T., Ly B., Cedilnik N., Cochet H., Sermesant M. (2021). Deep learning formulation of electrocardiographic imaging integrating image and signal information with data-driven regularization. Europace 23, I55–I62. 10.1093/europace/euaa391 - DOI - PubMed
    1. Bakker J. M. de, Van Capelle F. J., Janse M. J., Wilde A. A., Coronel R., Becker A. E., et al. (1988). Reentry as a cause of ventricular tachycardia in patients with chronic ischemic heart disease: electrophysiologic and anatomic correlation. Circulation 77, 589–606. 10.1161/01.cir.77.3.589 - DOI - PubMed
    1. Barr R. C., Ramsey M., Spach M. S. (1977). Relating epicardial to body surface potential distributions by means of transfer coefficients based on geometry measurements. IEEE Trans. Biomed. Eng. 24, 1–11. 10.1109/TBME.1977.326201 - DOI - PubMed
    1. Bear L. R., Bouhamama O., Cluitmans M., Duchateau J., Walton R. D., Abell E., et al. (2019a). Advantages and pitfalls of noninvasive electrocardiographic imaging. J. Electrocardiol. 57, S15–S20. 10.1016/j.jelectrocard.2019.08.007 - DOI - PubMed
    1. Bear L. R., Cluitmans M., Abell E., Rogier J., Labrousse L., Cheng L. K., et al. (2021). Electrocardiographic imaging of repolarization abnormalities. J. Am. Heart Assoc. 10, e020153. 10.1161/JAHA.120.020153 - DOI - PMC - PubMed

LinkOut - more resources