Estimation of activation sequence from time course of equivalent current density in pathological hearts — A simulation study

The equivalent current density (ECD) model has been previously used in the cardiac electrical imaging technique for non-invasively reconstructing the global activation sequence (AS) in the normal heart. However, its performance in estimating AS in the heart with structural defects remains uncertain. This study aims to evaluate its feasibility in two common cardiac structure diseases-ischemia and infarction, by performing forward simulation using a cellular automaton heart model. The AS was derived from ECD and quantitatively compared to the true AS simulated with the heart model by calculating correlation coefficient (CC) and relative error (RE). In ischemia condition, the ECD model returns a CC (0.97) and RE (0.13), comparable with those of normal heart. In infarction condition, it is also able to identify area of infarction and reconstruct global AS at the excitable myocardium with CC of 0.97 and RE of 0.12. The present pilot simulation results suggest the feasibility of applying ECD model in the pathological heart, which would help the investigation of pathology mechanism and clinical management of cardiac diseases.