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Simulation-based digital twinning of activation and repolarisation sequences from the ECG across healthy and diseased hearts

JA Coleman, J Camps, AI Hasaballa… - arXiv preprint arXiv …, 2025 - arxiv.org
Physics paper physics.med-ph Suggest

… This study aimed to develop and evaluate a simulation-based inference framework capable of reconstructing healthy and pathological ventricular repolarisation patterns …

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BibTeX

@article{2506.22243v1,
Author        = {James A Coleman and Julia Camps and Abdallah I Hasaballa and Alfonso Bueno-Orovio},
Title         = {Simulation-based digital twinning of activation and repolarisation
  sequences from the ECG across healthy and diseased hearts},
Eprint        = {2506.22243v1},
ArchivePrefix = {arXiv},
PrimaryClass  = {physics.med-ph},
Abstract      = {Abnormal patterns of ventricular repolarisation contribute to lethal
arrhythmias in various cardiac conditions, including inherited and acquired
channelopathies, cardiomyopathies, and ischaemic heart disease. However,
methods to detect these repolarisation abnormalities are limited.
  In this study, we introduce and assess a novel simulation-based method to
infer ventricular activation and repolarisation times from the 12-lead
electrocardiogram (ECG) and magnetic resonance-derived ventricular anatomical
reconstruction, applicable for the first time to both healthy controls and
cases with abnormal repolarisation.
  First, ventricular activation times were reconstructed through iterative
refinement of early activation sites and conduction velocities, until the model
and target QRS complexes matched. Then, ventricular repolarisation times were
reconstructed through iterative refinement of ventricular action potential
durations and an action potential shape parameter until the model and target T
waves matched, including regularisation. Repolarisation inference was evaluated
against 18 benchmark simulations with known repolarisation times, including
both control and hypertrophic cardiomyopathy (HCM) cases with abnormal
repolarisation.
  Inferred repolarisation times showed good agreement with the ground truth in
control and HCM (Spearman r=0.63+/-0.11 and 0.65+/-0.19, respectively), with
inferred model T waves closely matching the target T waves (r=0.81+/-0.05 and
0.78+/-0.08, respectively). The method further demonstrated flexibility in
reconstructing the macroscopic patterns of delayed repolarisation across a
range of abnormal ventricular repolarisation sequences, demonstrating
applicability to a range of pathological cases.
  Simulation-based inference can accurately reconstruct repolarisation times
from the 12-lead ECG in cases with both normal and abnormal repolarisation
patterns.},
Year          = {2025},
Month         = {Jun},
Url           = {http://arxiv.org/abs/2506.22243v1},
File          = {2506.22243v1.pdf}
}

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