We explored a potential clinical use of our application based on a spherically bounded model with homogeneous volume conductor to determine the location, orientation and strength of a single moving equivalent dipole (SMED) in 12-lead ECGs. We hypothesized that it would affect the location of the SMEDs in conduction defects. Using ECG criteria of AHA/ACCF/HRS, we studied subjects with left anterior fascicular block (LAFB, n=10) and those with left posterior fascicular block (LPFB, n=17), contrasting them with subjects with normal ECGs (n=42). The SMEDs were assessed in 5-min supine resting 12-lead ECGs with a time resolution of 1 ms. The heart axis through the centers of the derived atrial and ventricular SMED locations showed similar spatial orientation as that obtained by MRI studies. In LAFB and LPFB we found that the direction of the SMED trajectory and the SMED orientation rotate in the opposite sense and with different patterns, suggesting that these patterns could help in further discrimination of both blocks. This initial study with SMED assessment shows promising so far unexplored ECG-derived information. Further research in ECGs with various pathology is needed to investigate its possible diagnostic applicability.
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