Electrocardiogram (ECG) patterns of left anterior fascicular block and conduction impairment in ventricular myocardium: a whole-heart model-based simulation study

Yuan Gao, Ling Xia, Ying-lan Gong, Ding-chang Zheng

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Abstract

Left anterior fascicular block (LAFB) is a heart disease identifiable from an abnormal electrocardiogram (ECG). It has been reported that LAFB is associated with an increased risk of heart failure. Non-specific intraventricular conduction delay due to the lesions of the conduction bundles and slow cell to cell conduction has also been considered as another cause of heart failure. Since the location and mechanism of conduction delay have notable variability between individual patients, we hypothesized that the impaired conduction in the ventricular myocardium may lead to abnormal ECGs similar to LAFB ECG patterns. To test this hypothesis, based on a computer model with a three dimensional whole-heart anatomical structure, we simulated the cardiac exciting sequence map and 12-lead ECG caused by the block in the left anterior fascicle and by the slowed conduction velocity in the ventricular myocardium. The simulation results showed that the typical LAFB ECG patterns can also be observed from cases with slowed conduction velocity in the ventricular myocardium. The main differences were the duration of QRS and wave amplitude. In conclusion, our simulations provide a promising starting point to further investigate the underlying mechanism of heart failure with LAFB, which would provide a potential reference for LAFB diagnosis. the angulation of impaction having little effect on facture risk.
Original languageEnglish
Pages (from-to)49–56
Number of pages8
JournalJournal of Zhejiang University: Science B
Volume19
Issue number1
Early online date19 Jan 2018
DOIs
Publication statusPublished - Jan 2018
Externally publishedYes

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Bibliographical note

The final publication is available at Springer via http://dx.doi.org/10.1631/jzus.B1700029

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Keywords

  • Electrocardiogram (ECG)
  • Simulation
  • Heart model
  • Left anterior fascicular block (LAFB)

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