Enlarged atria are known to promote arrhythmia such as atrial flutter and its degeneration1 (PTF-V1). The suitability of these ECG markers in terms of sensitivity and specificity are discussed controversially.
In this work, in silico approach. Towards this end, a virtual population of up to 8 models comprising high-resolution bi-atrial anatomy and a torso mesh will be utilized. In a first step, the thickness of the LA wall will be varied using image processing techniques. In a second step, the LA will be dilated while keeping the volume of the myocardium constant. Finally, the two effects will be combined.
The effect of these LA anatomy alterations will be assessed by conducting excitation propagation simulations within both atria using the monodomain solver acCELLerate and subsequent computation of the Poisson problem within the torso yielding body surface potentials. Extraction of time series of these potentials provides the opportunity to evaluate the effect on the P-wave in the standard 12-lead ECG. The results will provide mechanistic insight in how the two anatomical features LA wall thickening and dilation translate into changes of the P-wave and might foster our understanding of the potential and limitations of various ECG markers assessing LA anatomy.