Simulating the ECG of ventricular tachyarrhythmias

The mechanisms of ventricular fibrillation (VF) remain poorly understood The aim of this study was to use a computational model of ventricular activation coupled to a torso model to assess whether the ECG contains information about the underlying mechanism of VF. We calculated the simECG from current dipoles in the Auckland canine ventricular geometry using the boundary element approach. Mobile re-entry produced a simECG signal similar to ventricular tachycardia, whilst multiple wavelet re-entry and rapid focal activity produced simECG signals similar to VF. Frequency analysis showed a stable modal frequency for the simECG of mobile re-entry, reflecting repetitive reentrant activity. In the other two simulations modal frequency increased during the first few seconds, reflecting a transition to more complex activity. This study suggests that the ECG may contain only limited information about VF mechanisms.