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Original Article

Korean Journal of Physiology and Pharmacology 2019; 23(1): 71-79

Published online January 1, 2019 https://doi.org/10.4196/kjpp.2019.23.1.71

Copyright © Korean J Physiol Pharmacol.

In silico evaluation of the acute occlusion effect of coronary artery on cardiac electrophysiology and the body surface potential map

Ah-Jin Ryu1,#, Kyung Eun Lee2,#, Soon-Sung Kwon1, Eun-Seok Shin3, Eun Bo Shim2,*

1SiliconSapiens Co, Seoul 06153, 2Department of Mechanical and Biomedical Engineering, Kangwon National University, Chuncheon 24341, 3Department of Cardiology, University of Ulsan College of Medicine, Ulsan 44033, Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Body surface potential map, an electric potential distribution on the body torso surface, enables us to infer the electrical activities of the heart. Therefore, observing electric potential projected to the torso surface can be highly useful for diagnosing heart diseases such as coronary occlusion. The BSPM for the heart of a patient show a higher level of sensitivity than 12-lead ECG. Relevant research has been mostly based on clinical statistics obtained from patients, and, therefore, a simulation for a variety of pathological phenomena of the heart is required. In this study, by using computer simulation, a body surface potential map was implemented according to various occlusion locations (distal, mid, proximal occlusion) in the left anterior descending coronary artery. Electrophysiological characteristics of the body surface during the ST segment period were observed and analyzed based on an ST isointegral map. We developed an integrated system that takes into account the cellular to organ levels, and performed simulation regarding the electrophysiological phenomena of the heart that occur during the first 5 minutes (stage 1) and 10 minutes (stage 2) after commencement of coronary occlusion. Subsequently, we calculated the bipolar angle and amplitude of the ST isointegral map, and observed the correlation between the relevant characteristics and the location of coronary occlusion. In the result, in the ventricle model during the stage 1, a wider area of ischemia led to counterclockwise rotation of the bipolar angle; and, during the stage 2, the amplitude increased when the ischemia area exceeded a certain size.

Keywords: Acute coronary occlusion, Body surface potential map, Coronary artery, Electrophysiology, In silico