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Non-Invasive and Quantitative Estimation of Left Atrial Fibrosis Based on P Waves of the 12-Lead ECG—A Large-Scale Computational Study Covering Anatomical Variability

Nagel, Claudia 1; Luongo, Giorgio 1; Azzolin, Luca 1; Schuler, Steffen 1; Dössel, Olaf 1; Loewe, Axel ORCID iD icon 1
1 Institut für Biomedizinische Technik (IBT), Karlsruher Institut für Technologie (KIT)


The arrhythmogenesis of atrial fibrillation is associated with the presence of fibrotic atrial tissue. Not only fibrosis but also physiological anatomical variability of the atria and the thorax reflect in altered morphology of the P wave in the 12-lead electrocardiogram (ECG). Distinguishing between the effects on the P wave induced by local atrial substrate changes and those caused by healthy anatomical variations is important to gauge the potential of the 12-lead ECG as a non-invasive and cost-effective tool for the early detection of fibrotic atrial cardiomyopathy to stratify atrial fibrillation propensity. In this work, we realized 54,000 combinations of different atria and thorax geometries from statistical shape models capturing anatomical variability in the general population. For each atrial model, 10 different volume fractions (0–45%) were defined as fibrotic. Electrophysiological simulations in sinus rhythm were conducted for each model combination and the respective 12-lead ECGs were computed. P wave features (duration, amplitude, dispersion, terminal force in V1) were extracted and compared between the healthy and the diseased model cohorts. ... mehr

Verlagsausgabe §
DOI: 10.5445/IR/1000135476
Veröffentlicht am 19.07.2021
DOI: 10.3390/jcm10081797
Zitationen: 21
Zitationen: 29
Cover der Publikation
Zugehörige Institution(en) am KIT Institut für Biomedizinische Technik (IBT)
Publikationstyp Zeitschriftenaufsatz
Publikationsjahr 2021
Sprache Englisch
Identifikator ISSN: 2077-0383
KITopen-ID: 1000135476
Erschienen in Journal of Clinical Medicine
Verlag MDPI
Band 10
Heft 8
Seiten Art.-Nr.: 1797
Bemerkung zur Veröffentlichung Gefördert durch den KIT-Publikationsfonds
Vorab online veröffentlicht am 20.04.2021
Schlagwörter electrophysiological simulation; atrial cohort modeling; 12-lead ECG; P wave; atrial fibrosis; atrial fibrillation
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