The uniform double layer model and myocardial infarction: forward solution consideration.

The Uniform Double Layer (UDL) model of the cardiac generator is often used for forward simulation of body surface potentials (BSPs). The model also proved to be very useful for the inverse computation of heart activation. However, for the purposes of Myocardial Infarction (MI) modelling mostly the Multiple Dipole (MD) models are used. In our study, the ability of UDL model to represent the activation of the heart with an old MI was examined. The finite element model of the heart was used to simulate electrical activation of the heart with an old MI. Different locations of endocardial MI were used. For each of them three cases were considered according to the scale of the infarcted area: small and medium endocardial and large transmural. For the further computation of the electric field within the torso volume conductor two types of UDL representation of the cardiac generator were used. For the first UDL model, supposing the scared tissue to be unexcitable, an "infarcted" surface (different from the "healthy" surface) of activated myocardium was generated for each case of MI. Times when activation wavefront reached particular nodes on the surface served as an input for the forward computation of BSPs. To be able to understand the behaviour of the UDL, we also created the second UDL model, where the "infarcted activation sequence" was approximated on the original "healthy" heart surface. The BSPs were computed for each case of MI using both UDL cardiac generators. The boundary element method with the inhomogeneous volume conductor was used for computations. The BSPs generated by both models for the same case of MI were compared using the correlation coefficient. The results show, that it is possible to find an approximation of the "infarcted activation sequence" on the "healthy" heart generator surface in a way that BSPs generated by both models have a correlation coefficient higher than 0.96 for the entire period of depolarisation. Visualisation of the epicardial isochrones might help to understand the UDL model behaviour under the MI conditions. It would be useful for the correct interpretation of the results when using the UDL model for inverse solution. (Fig. 7, Ref. 5.)