Numerical simulation of electrocardiograms for full cardiac cycles in healthy and pathological conditions.

This work is dedicated to the simulation of full cycles of the electrical activity of the heart and the corresponding body surface potential. The model is based on a realistic torso and heart anatomy, including ventricles and atria. One of the specificities of our approach is to model the atria as a surface, which is the kind of data typically provided by medical imaging for thin volumes. The bidomain equations are considered in their usual formulation in the ventricles, and in a surface formulation on the atria. Two ionic models are used: the Courtemanche-Ramirez-Nattel model on the atria and the 'minimal model for human ventricular action potentials' by Bueno-Orovio, Cherry, and Fenton in the ventricles. The heart is weakly coupled to the torso by a Robin boundary condition based on a resistor-capacitor transmission condition. Various electrocardiograms (ECGs) are simulated in healthy and pathological conditions (left and right bundle branch blocks, Bachmann's bundle block, and Wolff-Parkinson-White syndrome). To assess the numerical ECGs, we use several qualitative and quantitative criteria found in the medical literature. Our simulator can also be used to generate the signals measured by a vest of electrodes. This capability is illustrated at the end of the article. Copyright © 2015 John Wiley & Sons, Ltd.