A Multiscale Investigation of Global Electrical Heterogeneity: Effects of Body Habitus, Respiration, and Tissue Conductivity

Abstract

Extracardiac factors such as respiration, fluid overload and body habitus have important effects on the ECG voltage. Vectorcardiographic (VCG) Global Electrical Heterogeneity (GEH) is associated with sudden cardiac death (SCD). Risk of SCD is especially high in end-stage renal disease patients (ESRD) on dialysis. However, extracardiac factors challenge ECG interpretation in ESRD patients. The effects of extracardiac factors on GEH have not been fully studied. To assess effects of extracardiac factors on ECG, we conducted a multi-scale study. An experimental data of ESRD patients and a previously developed biophysically detailed heart-torso model were used to investigate the effects of respiration, fluid overload and body habitus on the VCG and GEH.

Tpeak‐Tend ECG Marker in Obesity and Cardiovascular Diseases: A Comprehensive Review

“…In trying to explain the conflicting results, it should be taken into account that both cardiac and extracardiac factors matter in the case of surface ECG. There may be a potential effect of extracardiac factors such as subcutaneous fat, heart position, fluid overload, and body habitus on the temporal parameters, not only on voltage parameters, which cannot be excluded entirely [ 48 ]. Generally, Tp-e is thought to reflect dispersion of repolarization, and this is an intracardiac factor.…”