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Biomedical subjects

R Plonsey

Publications and source records attributed to R Plonsey.

At least 73 records · Page 4Linked to original sources

Electrocardiographic body surface potential maps of the QRS of normal children.

Electrocardiographic body surface potential maps (BSPM), utilizing 180 active dry electrodes imbedded in an inflatable vest, were obtained in 40 normal children, ages 8 to 18. The potential levels of the maps are displayed as different colors. A qualitative analysis indicated that the onset of right ventricular breakthrough could always be recognized in the upstroke of the QRS by a pseudopod from a right shoulder minimum extending into an anterior maximum, at an average of 24.4 +/- 4.2 msec., for an average QRS duration of 75.0 +/- 7.1 msec. However there was considerable normal variation, particularly in the mid and late QRS. At the time of depolarization of the free walls of the ventricles, the maximum often remained anterior, with an extension posterior, even through the Frank system vectorcardiogram invariably was posterior. Most remarkable was the terminal QRS of the BSPM, where the terminal maximum may be right superior anterior, anterior superior, or right posterior, presumably reflecting the right ventricular outflow tract, the superior septum, or the posterior basal left ventricle.

Adolescent↗

A contemporary view of the ventricular gradient of Wilson.

We have derived quantitative expressions for QRS, T, and QRST areas of the scalar electrocardiogram. The QRST area, or ventricular gradient, is seen to be essentially independent of the activation sequence and to reflect recovery properties of the tissue as weighted by the vector lead field of a given lead. The results are derived for uniform isotropic conditions and under the assumption that the temporal waveforms everywhere are identical except for possible variations in the duration of the plateau. However, it is noted that the results are, probably, valid under anisotropic conditions as well. The examination of ventricular gradients from epicardial and intramural leads should reflect local recovery properties and be a useful tool in study of the physiology of recovery, as well as the study of arrhythmias.

Arrhythmias, Cardiac↗

The effects of variations in conductivity and geometrical parameters on the electrocardiogram, using an eccentric spheres model.

The effects of variations in the volume conductor properties of the torso on the electrocardiogram were studied by means of a theoretical eccentric spheres model. The model includes a blood cavity, cardiac muscle layer, pericardium, lung region, skeletal muscle layer, and subcutaneous fat. The source of the field is a double-layer spherical cap located within the myocardium. The following effects regarding the electrocardiogram (ECG) potentials were determined: (1) blood augments the potential, but less than predicted by simpler published models; (2) in anemia, high potentials are expected, whereas in polycythemia, voltages are reduced; (3) abnormally low lung conductivity (emphysema) causes low surface potentials whose magnitude is controlled by the low conductivity skeletal muscle layer; (4) low voltages result both from low and high pericardial conductivities; (5) the surface potential increases with increasing myocardial conductivity; (6) low skeletal muscle conductivity (Pompe's disease) causes high surface potentials; (7) obesity lowers the potential only slightly; (8) a thick myocardium, protruding into the lung region, slightly augments the potential; (9) an increase in the thickness of the myocardium at the expense of the blood cavity causes a decrease in potential; (10) the potential increases with increasing heart size; and (11) the location of the heart within the torso has a very significant effect on the surface potential distribution.

Action Potentials↗

A note on the "Brody-effect".

The effect of a perfectly conducting sphere simulating the intracavitary blood mass on a dipole source located at the interface with the outer tissue (myocardium) is studied, utilizing image theory. The resulting enhancement factor is found to be a function of the field point location and is not a constant, as previously reported by Brody and by Rush and Nelson.

Blood↗

A cellular model for the simulation of activation in the ventricular myocardium.

A digital computer model of cardiac activation was used to investigate the relationship between cellular orientation and conduction and propagation of the ventricular activation wave front. The results of the simulation for a single cycle initiated in fully recovered tissue under normal and simplified pathological conditions (ischemia and infaraction) indicate (a) that the conduction velocity of the cellular action potential in ventricular cardiac tissue may be several (3-5) times greater than is normally considered to be the case, (b) that the ventricular activation wave front propagates transmurally from endocardium to epicardium despite fiber orientation parallel to these surfaces, without the need for assuming the existence of either lateral contacts between adjacent cells or fibers with a transmural orientation, (c) the wave front of activation propagates through ventricular cardiac tissue with an anisotropic phase velocity, (d) the presence of ischemia and infarction gives rise to tangential spread of activation, and (e) small subendocardial infarcts should not be considered to be electrically silent.

Action Potentials↗