An in-silico analysis of the effect of heart position and orientation on the ECG morphology and vectorcardiogram parameters in patients with heart failure and intraventricular conduction defects

Uyen Chau Nguyen, Mark Potse*, Francois Regoli, Maria Luce Caputo, Giulio Conte, Romina Murzilli, Stefano Muzzarelli, Tiziano Moccetti, Enrico G. Caiani, Frits W. Prinzen, Rolf Krause, Angelo Auricchio

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

26 Citations (Web of Science)


Aim: The aim of this study was to investigate the influence of geometrical factors on the ECG morphology and vectorcardiogram (VCG) parameters. Methods: Patient-tailored models based on five heart-failure patients with intraventricular conduction defects (IVCDs) were created. The heart was shifted up to 6 cm to the left, right, up, and down and rotated +/- 30 degrees around the anteroposterior axis. Precordial electrodes were shifted 3 cm down. Results: Geometry modifications strongly altered ECG notching/slurring and intrinsicoid deflection time. Maximum VCG parameter changes were small for QRS duration (-6% to +10%) and QRS-T angle (-6% to +3%), but considerable for QRS amplitude (-36% to +59%), QRS area (-37% to +42%), T-wave amplitude (-41% to +36%), and T-wave area (-42% to +33%). Conclusion: The position of the heart with respect to the electrodes is an important factor determining notching/slurring and voltage-dependent parameters and therefore must be considered for accurate diagnosis of IVCDs.
Original languageEnglish
Pages (from-to)617-625
JournalJournal of Electrocardiology
Issue number4
Publication statusPublished - 2015


  • Geometry
  • ECG morphology
  • VCG
  • Computer simulation

Cite this