Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Gillette, K; Winkler, B; Kurath-Koller, S; Scherr, D; Vigmond, EJ; Bär, M; Plank, G.
A computational study on the influence of antegrade accessory pathway location on the 12-lead electrocardiogram in Wolff-Parkinson-White syndrome.
Europace. 2025; 27(2):
Doi: 10.1093/europace/euae223
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- Führende Autor*innen der Med Uni Graz
- Gillette Karli
- Co-Autor*innen der Med Uni Graz
- Kurath-Koller Stefan
- Plank Gernot
- Scherr Daniel
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- Abstract:
- AIMS: Wolff-Parkinson-White (WPW) syndrome is a cardiovascular disease characterized by abnormal atrioventricular conduction facilitated by accessory pathways (APs). Invasive catheter ablation of the AP represents the primary treatment modality. Accurate localization of APs is crucial for successful ablation outcomes, but current diagnostic algorithms based on the 12-lead electrocardiogram (ECG) often struggle with precise determination of AP locations. In order to gain insight into the mechanisms underlying localization failures observed in current diagnostic algorithms, we employ a virtual cardiac model to elucidate the relationship between AP location and ECG morphology. METHODS AND RESULTS: We first introduce a cardiac model of electrophysiology that was specifically tailored to represent antegrade APs in the form of a short atrioventricular bypass tract. Locations of antegrade APs were then automatically swept across both ventricles in the virtual model to generate a synthetic ECG database consisting of 9271 signals. Regional grouping of antegrade APs revealed overarching morphological patterns originating from diverse cardiac regions. We then applied variance-based sensitivity analysis relying on polynomial chaos expansion on the ECG database to mathematically quantify how variation in AP location and timing relates to morphological variation in the 12-lead ECG. We utilized our mechanistic virtual model to showcase the limitations of AP localization using standard ECG-based algorithms and provide mechanistic explanations through exemplary simulations. CONCLUSION: Our findings highlight the potential of virtual models of cardiac electrophysiology not only to deepen our understanding of the underlying mechanisms of WPW syndrome but also to potentially enhance the diagnostic accuracy of ECG-based algorithms and facilitate personalized treatment planning.
- Find related publications in this database (using NLM MeSH Indexing)
- Wolff-Parkinson-White Syndrome - physiopathology, diagnosis, surgery
- Humans - administration & dosage
- Electrocardiography - methods
- Accessory Atrioventricular Bundle - physiopathology, surgery, diagnosis
- Models, Cardiovascular - administration & dosage
- Catheter Ablation - methods
- Action Potentials - administration & dosage
- Algorithms - administration & dosage
- Predictive Value of Tests - administration & dosage
- Heart Rate - administration & dosage
- Signal Processing, Computer-Assisted - administration & dosage
- Electrophysiologic Techniques, Cardiac - methods
- Computer Simulation - administration & dosage
- Find related publications in this database (Keywords)
- Wolff-Parkinson-White syndrome
- Cardiac digital twins
- 12-lead ECG
- Uncertainty quantification
- Sensitivity analysis
- Accessory pathways
- Virtual models of cardiac electrophysiology