TY - CHAP M1 - Book, Section TI - Chapter 15. Cardiac Simulation for Education: The Electrocardiogram According to Ecgsim A1 - van Oosterom, Adriaan A1 - Oostendorp, Thom F. A2 - Pahlm, Olle A2 - Wagner, Galen S. PY - 2011 T2 - Multimodal Cardiovascular Imaging: Principles and Clinical Applications AB - Most diagnostic methods used in clinical electrocardiography (ECG) are statistically based forms of pattern recognition. Over the years, the selection of the signal features used in these methods, such as timing, amplitude, and duration of wavelets, has been guided by knowledge gathered through linking clinical observations with ECG waveforms, along with insight gained from invasive electrophysiology. These methods have reached a diagnostic accuracy of up to 90% in some categories of cardiac disease. However, in other categories, the performance is much lower. Moreover, the manifestation in the ECG of some types of abnormality remains poorly understood. Examples of these problematic domains are the diagnosis of left ventricular hypertrophy, the interpretation of ST changes during acute ischemia, the electric manifestation of the Brugada syndrome, and the long QT syndrome. What these examples have in common is that the major features that play a role in the related ECG analysis are their waveforms, which are the result of the electric depolarization and repolarization processes of the membranes of cardiac myocytes, rather than rhythm abnormalities. Since Einthoven's day (late nineteenth century/early twentieth century),1,2 the development of diagnostic ECG criteria has been accompanied by the development of biophysical models aimed at linking the electrophysiology of cardiac function with the waveforms of the ECG signals observed on the body surface. In such an approach, two aspects of the bioelectric generator need to be specified—a source model of the cardiac electric activity, and a volume conductor model, which is a model for describing the passive effects on the observed data of the body tissues that surround the active electric sources. SN - PB - The McGraw-Hill Companies CY - New York, NY Y2 - 2024/03/28 UR - accessmedicine.mhmedical.com/content.aspx?aid=8763384 ER -