On the potential of the wilson central terminal with respect to an ideal reference for unipolar electrocardiography

Miyamoto, Norio; Shimizu, Yutaka; Nishiyama, Genyo; Mashima, Saburo; Okamoto, Yoshio

doi:10.1016/s0022-0736(05)80054-8

Cited by 4 publications

(3 citation statements)

References 2 publications

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“…Estimates of the actual potential at WCT have been made with respect to an infinite reference using body surface potential data, and they are close enough to each other to be considered equivalent. 7 WCT is also used as the reference for unipolar intracardiac signals, and this will be discussed in detail later. Several approximations exist when acquiring unipolar signals.…”

Section: Overview Of a Typical Data Acquisition Systemmentioning

confidence: 99%

Signals and Signal Processing for the Electrophysiologist

Venkatachalam

Herbrandson

Asirvatham

2011

Circ: Arrhythmia and Electrophysiology

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Section: Overview Of a Typical Data Acquisition Systemmentioning

confidence: 99%

Signals and Signal Processing for the Electrophysiologist

Venkatachalam

Herbrandson

Asirvatham

2011

Circ: Arrhythmia and Electrophysiology

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“…Before delving into the full explanation of our method, we must mention that Wilson’s hypothesis and the related triangle to star transformation has been challenged at both the theoretical [ 8 , 9 , 10 , 11 , 12 , 13 ] and practical level [ 2 , 3 , 6 , 10 , 11 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ] several times in the past 80 years, with several researchers confirming that, contrary to what Wilson’s principal postulates [ 1 , 22 , 23 ], the amplitude of the WCT can be comparable to (or even larger than) the limb leads, and can exhibit variability during the cardiac cycle similar to any other ECG signal [ 2 , 8 , 10 , 16 , 24 , 25 , 26 , 27 , 28 ]. Still, as already mentioned, one may note that the original instrument that both Einthoven and Wilson used to formalize the triangular ECG model and the WCT was measuring the current impressed by the heart to the body surface, while modern electrocardiography uses voltage amplifiers [ 28 ].…”

Section: Methodsmentioning

confidence: 99%

On the Einthoven Triangle: A Critical Analysis of the Single Rotating Dipole Hypothesis

Bifulco

Cesarelli

McEwan

et al. 2018

Sensors

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Since its inception, electrocardiography has been based on the simplifying hypothesis that cardinal limb leads form an equilateral triangle of which, at the center/centroid, the electrical equivalent of the cardiac activity rotates during the cardiac cycle. Therefore, it is thought that the three limbs (right arm, left arm, and left leg) which enclose the heart into a circuit, where each branch directly implies current circulation through the heart, can be averaged together to form a stationary reference (central terminal) for precordials/chest-leads. Our hypothesis is that cardinal limbs do not form a triangle for the majority of the duration of the cardiac cycle. As a corollary, the central point may not lie in the plane identified by the limb leads. Using a simple and efficient algorithm, we demonstrate that the portion of the cardiac cycle where the three limb leads form a triangle is, on average less, than 50%.

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“…Since then efforts are made to understand the error introduced by using the WCT in ECG-measurements [145][146][147][148] and efforts were taken to derive a zero potential based on the measurements [149]. In 2018 Moeinzadeh et al [150] tried to minimise the fluctuations of the WCT in time by finding (constant) weights for the individual measurement electrodes with a genetic algorithm.…”

Section: Referencing the Ecg In Timementioning

confidence: 99%

Reconstructing the electrical dynamics on the heart

Rüchardt¹

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The heart is an electro-mechanical system. In 2010 about 4.25 million people died from cardiac arrhythmias. Immediate treatment in case of fibrillation is to shock the heart electrically with high energy to reset the electrical system. However high energy shocks cause severe side effects: the heart tissue is damaged, patients develop anxiety and panic disorders. To reduce these side effects low energy defibrillation methods are developed in the research group biomedical physics (RGBMP) at the Max Planck Institute for Dynamics and Self-Organization.Low energy defibrillation is researched in-vivo and ex-vivo using extracted hearts in Langendorff perfusion. In these experiments the current used for defibrillation is drastically reduced, therefore it is important to understand where the current employed interacts with the heart. For this thesis I rebuilt the experimental setups including shock electrodes and ECG-measurement panels of the RGBMP in-silico using the software Gmsh for computer augmented design (and subsequent computational mesh generation). I extracted the anatomical features of the torso, the heart and the heart muscle's fibre orientation from medical image data and I combined both to create geometrical models of the in-vivo and ex-vivo experiments. I implemented a numerical framework to calculate the current flow in these models and conducted simulation studies together with Master student Simon Wassing.We found out that the ratio of the total current that interacts with the heart is between 8 % and 15 % of the total current depending on the heart size. Also the positioning of the heart with respect to the electrodes changes the current. We found out that by lowering the heart from a centralised position of the heart between the electrodes in z direction the current flowing through the heart can be increased by up to 20 %.Patients with a high risk of cardiac fibrillation usually are under pharmaceutical treatment. If this fails ablation therapy is applied. In ablation therapy parts of the heart are burned either by heat or by cold to stabilize the electrical system in the heart to reduce the probability of arrhythmias. A method called inverse ECG or ECG imaging is researched worldwide to provide information about the properties of the heart tissue to identify the regions to burn. I extended the numerical framework with a method for cardiac electric dynamics, potential reconstruction, diffusion of the potential into the vicinity of the bath and ECG signal integration.The source of the ECG signals is a potential distribution at the outside of the heart. They are referenced against other ECG electrodes to handle that fact that potentials are only defined up to a constant. This can be interpreted as the ECG signal being 8.

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On the potential of the wilson central terminal with respect to an ideal reference for unipolar electrocardiography

Cited by 4 publications

References 2 publications

Signals and Signal Processing for the Electrophysiologist

Signals and Signal Processing for the Electrophysiologist

On the Einthoven Triangle: A Critical Analysis of the Single Rotating Dipole Hypothesis

Reconstructing the electrical dynamics on the heart

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