The interplay between structural and electrical changes in the heart after myocardial infarction (MI) plays a key role in the initiation and maintenance of arrhythmia. The anatomical and electrophysiological properties of scar, border zone, and normal myocardium modify the electrocardiographic morphology, which is routinely analysed in clinical settings. However, the influence of various MI properties on the QRS is not intuitively predictable.In this work, we have systematically investigated the effects of 17 post-MI scenarios, varying the location, size, transmural extent, and conductive level of scarring and border zone area, on the forward-calculated QRS. Additionally, we have compared the contributions of different QRS score criteria for quantifying post-MI pathophysiology.The propagation of electrical activity in the ventricles is simulated via a Eikonal model on a unified coordinate system.The analysis has been performed on 49 subjects, and the results imply that the QRS is capable of identifying MI, suggesting the feasibility of inversely reconstructing infarct regions from QRS.There exist sensitivity variations of different QRS criteria for identifying 17 MI scenarios, which is informative for solving the inverse problem.

翻译：心肌梗死后心脏结构性与电学变化之间的相互作用在心律失常的诱发与维持中起关键作用。瘢痕组织、边界区及正常心肌的解剖与电生理特性会改变心电图形态，这一特征在临床常规分析中具有重要价值。然而，不同心肌梗死特性对QRS波群的影响尚无法直观预测。本研究系统探讨了17种心肌梗死后场景（通过改变瘢痕与边界区的定位、尺寸、透壁程度及传导性能）对前向计算QRS波群的影响，并比较了不同QRS评分标准在量化梗死后病理生理学中的贡献。采用统一坐标系下的Eikonal模型仿真心室电活动传导过程。基于49个受试者的分析结果表明，QRS波群能够识别心肌梗死，提示通过QRS波群反向重建梗死区域具有可行性。不同QRS评分标准对17种心肌梗死场景的识别灵敏度存在差异，这一发现可为解决逆问题提供参考依据。