{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T03:23:15Z","timestamp":1787973795465,"version":"build-2784847793"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"Supplement_1","license":[{"start":{"date-parts":[[2021,3,1]],"date-time":"2021-03-01T00:00:00Z","timestamp":1614556800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Netherlands Cardiovascular Research Initiative"},{"DOI":"10.13039\/501100002996","name":"Dutch Heart Foundation","doi-asserted-by":"crossref","award":["2018B007"],"award-info":[{"award-number":["2018B007"]}],"id":[{"id":"10.13039\/501100002996","id-type":"DOI","asserted-by":"crossref"}]},{"name":"UCL Hospitals NIHR Biomedical Research Centre"},{"name":"Theo-Rossi di Montelera (TRM) foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,3,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Ventricular conduction disorders can induce arrhythmias and impair cardiac function. Bundle branch blocks (BBBs) are diagnosed by 12-lead electrocardiogram (ECG), but discrimination between BBBs and normal tracings can be challenging. CineECG computes the temporo-spatial trajectory of activation waveforms in a 3D heart model from 12-lead ECGs. Recently, in Brugada patients, CineECG has localized the terminal components of ventricular depolarization to right ventricle outflow tract (RVOT), coincident with arrhythmogenic substrate localization detected by epicardial electro-anatomical maps. This abnormality was not found in normal or right BBB (RBBB) patients. This study aimed at exploring whether CineECG can improve the discrimination between left BBB (LBBB)\/RBBB, and incomplete RBBB (iRBBB).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We utilized 500 12-lead ECGs from the online Physionet-XL-PTB-Diagnostic ECG Database with a certified ECG diagnosis. The mean temporo-spatial isochrone trajectory was calculated and projected into the anatomical 3D heart model. We established five CineECG classes: \u2018Normal\u2019, \u2018iRBBB\u2019, \u2018RBBB\u2019, \u2018LBBB\u2019, and \u2018Undetermined\u2019, to which each tracing was allocated. We determined the accuracy of CineECG classification with the gold standard diagnosis. A total of 391 ECGs were analysed (9 ECGs were excluded for noise) and 240\/266 were correctly classified as \u2018normal\u2019, 14\/17 as \u2018iRBBB\u2019, 55\/55 as \u2018RBBB\u2019, 51\/51 as \u2018LBBB\u2019, and 31 as \u2018undetermined\u2019. The terminal mean temporal spatial isochrone contained most information about the BBB localization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CineECG provided the anatomical localization of different BBBs and accurately differentiated between normal, LBBB and RBBB, and iRBBB. CineECG may aid clinical diagnostic work-up, potentially contributing to the difficult discrimination between normal, iRBBB, and Brugada patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/europace\/euaa396","type":"journal-article","created":{"date-parts":[[2020,12,3]],"date-time":"2020-12-03T23:29:29Z","timestamp":1607038169000},"page":"i80-i87","source":"Crossref","is-referenced-by-count":15,"title":["Novel\n                    <i>CineECG<\/i>\n                    enables anatomical 3D localization and classification of bundle branch blocks"],"prefix":"10.1093","volume":"23","author":[{"given":"Machteld J","family":"Boonstra","sequence":"first","affiliation":[{"name":"Division Heart & Lungs, Department of Cardiology, University Medical Center Utrecht, Utrecht 3508 GA, Heidelberglaan 100, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bashar N","family":"Hilderink","sequence":"additional","affiliation":[{"name":"Division Heart & Lungs, Department of Cardiology, University Medical Center Utrecht, Utrecht 3508 GA, Heidelberglaan 100, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuela T","family":"Locati","sequence":"additional","affiliation":[{"name":"Department of Arrhythmology and Electrophysiology, IRCCS Policlinico San Donato, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1692-8669","authenticated-orcid":false,"given":"Folkert W","family":"Asselbergs","sequence":"additional","affiliation":[{"name":"Division Heart & Lungs, Department of Cardiology, University Medical Center Utrecht, Utrecht 3508 GA, Heidelberglaan 100, Utrecht, The Netherlands"},{"name":"Netherlands Heart Institute, Utrecht, The Netherlands"},{"name":"Institute of Cardiovascular Science, Institute of Health Informatics, Faculty of Population Health Sciences, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Loh","sequence":"additional","affiliation":[{"name":"Division Heart & Lungs, Department of Cardiology, University Medical Center Utrecht, Utrecht 3508 GA, Heidelberglaan 100, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7962-1760","authenticated-orcid":false,"given":"Peter M","family":"van Dam","sequence":"additional","affiliation":[{"name":"Division Heart & Lungs, Department of Cardiology, University Medical Center Utrecht, Utrecht 3508 GA, Heidelberglaan 100, Utrecht, The Netherlands"},{"name":"ECG Excellence BV, Nieuwerbrug aan den Rijn, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,3,4]]},"reference":[{"key":"2021031001583154800_euaa396-B1","volume-title":"Eine Anatomisch-Histologische Studie \u00dcber das Atrioventrikularb\u00fcndel und die Purkinjeschen Faden","author":"Tawara","year":"1906"},{"key":"2021031001583154800_euaa396-B2","first-page":"70","article-title":"Die Topographie und Histologie der Bruckenfasern. Ein Beitrag zur Lehre von der Bedeutung der Purkinjeschen faden","volume":"19","author":"Tawara","year":"1906","journal-title":"Zentralb Physiol"},{"key":"2021031001583154800_euaa396-B3","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1136\/hrt.34.8.807","article-title":"Histopathological examination of concept of left hemiblock","volume":"34","author":"Demoulin","year":"1972","journal-title":"Br Heart J"},{"key":"2021031001583154800_euaa396-B4","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1161\/01.RES.73.3.482","article-title":"Immunohistochemical delineation of the conduction system. II: the atrioventricular node and Purkinje fibers","volume":"73","author":"Oosthoek","year":"1993","journal-title":"Circ Res"},{"key":"2021031001583154800_euaa396-B5","first-page":"e382","article-title":"2018 ACC\/AHA\/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay: a report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society","volume":"140","author":"Kusumoto","year":"2019","journal-title":"Circulation"},{"key":"2021031001583154800_euaa396-B6","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1016\/j.amjcard.2010.11.010","article-title":"Defining left bundle branch block in the era of cardiac resynchronization therapy","volume":"107","author":"Strauss","year":"2011","journal-title":"Am J Cardiol"},{"key":"2021031001583154800_euaa396-B7","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1161\/01.CIR.69.5.914","article-title":"Endocardial activation of left bundle branch block","volume":"69","author":"Vassallo","year":"1984","journal-title":"Circulation"},{"key":"2021031001583154800_euaa396-B8","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1054\/jelc.2001.25431","article-title":"Clinical consequences of ST-segment changes caused by body position mimicking transient myocardial ischemia: hazards of ST-segment monitoring?","volume":"34","author":"Drew","year":"2001","journal-title":"J Electrocardiol"},{"key":"2021031001583154800_euaa396-B9","first-page":"118","article-title":"Precordial electrode placement in women","volume":"11","author":"Macfarlane","year":"2003","journal-title":"Neth Heart J"},{"key":"2021031001583154800_euaa396-B10","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1016\/j.ejim.2012.03.011","article-title":"The effects of electrode misplacement on clinicians; interpretation of the standard 12-lead electrocardiogram","volume":"23","author":"Bond","year":"2012","journal-title":"Eur J Intern Med"},{"key":"2021031001583154800_euaa396-B11","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1161\/01.RES.2.3.258","article-title":"General theory of heart-vector projection","volume":"2","author":"Frank","year":"1954","journal-title":"Circ Res"},{"key":"2021031001583154800_euaa396-B12","doi-asserted-by":"crossref","first-page":"1816","DOI":"10.1093\/europace\/eut132","article-title":"Evaluating strict and conventional left bundle branch block criteria using electrocardiographic simulations","volume":"15","author":"Galeotti","year":"2013","journal-title":"Europace"},{"key":"2021031001583154800_euaa396-B13","doi-asserted-by":"crossref","first-page":"E1939","DOI":"10.1016\/S0735-1097(12)61940-8","article-title":"The significance of incomplete and complete right bundle branch blocks in young adults","volume":"59","author":"Nasir","year":"2012","journal-title":"J Am Coll Cardiol"},{"key":"2021031001583154800_euaa396-B14","doi-asserted-by":"crossref","first-page":"2290","DOI":"10.1016\/j.jacc.2011.08.039","article-title":"New electrocardiographic criteria for discriminating between Brugada types 2 and 3 patterns and incomplete right bundle branch block","volume":"58","author":"Chevallier","year":"2011","journal-title":"J Am Coll Cardiol"},{"key":"2021031001583154800_euaa396-B15","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1016\/j.jelectrocard.2017.08.010","article-title":"A new anatomical view on the vector cardiogram: the mean temporal-spatial isochrones","volume":"50","author":"van Dam","year":"2017","journal-title":"J Electrocardiol"},{"key":"2021031001583154800_euaa396-B16","first-page":"1","article-title":"Mean temporal spatial isochrones direction as marker for activation delay in patients with arrhythmogenic cardiomyopathy","volume":"45","author":"Roudijk","year":"2018","journal-title":"Comput Cardiol"},{"key":"2021031001583154800_euaa396-B17","doi-asserted-by":"crossref","first-page":"e008524","DOI":"10.1161\/CIRCEP.120.008524","article-title":"Novel CineECG derived from standard 12-lead ECG enables right ventricle outflow tract localization of electrical substrate in patients with Brugada syndrome","volume":"13","author":"van Dam","year":"2020","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"2021031001583154800_euaa396-B18","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1161\/01.CIR.41.6.899","article-title":"Total excitation of the isolated human heart","volume":"41","author":"Durrer","year":"1970","journal-title":"Circulation"},{"key":"2021031001583154800_euaa396-B19","doi-asserted-by":"crossref","first-page":"e235","DOI":"10.1161\/CIRCULATIONAHA.108.191095","article-title":"AHA\/ACCF\/HRS recommendations for the standardization and interpretation of the electrocardiogram: part III: intraventricular conduction disturbances: a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society: endorsed by the International Society for Computerized Electrocardiology","volume":"119","author":"Surawicz","year":"2009","journal-title":"Circulation"},{"key":"2021031001583154800_euaa396-B20","doi-asserted-by":"crossref","first-page":"e006497","DOI":"10.1161\/CIRCEP.118.006497","article-title":"QRS area is a strong determinant of outcome in cardiac resynchronization therapy","volume":"11","author":"van Stipdonk","year":"2018","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"2021031001583154800_euaa396-B21","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1016\/j.jelectrocard.2014.08.005","article-title":"Sensitivity of CIPS-computed PVC location to measurement errors in ECG electrode position: the need for the 3D camera","volume":"47","author":"van Dam","year":"2014","journal-title":"J Electrocardiol"},{"key":"2021031001583154800_euaa396-B22","first-page":"4","article-title":"Automatic registration of 3D camera recording to model for leads localization","volume":"44","author":"Alioui","year":"2017","journal-title":"Comput Cardiol"},{"key":"2021031001583154800_euaa396-B23","first-page":"iv16","article-title":"Localization of premature ventricular contractions from the papillary muscles using the standard 12-lead electrocardiogram: a feasibility study using a novel cardiac isochrone positioning system","volume":"18","author":"van Dam","year":"2016","journal-title":"Europace"}],"container-title":["EP Europace"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/europace\/article-pdf\/23\/Supplement_1\/i80\/36455706\/euaa396.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/europace\/article-pdf\/23\/Supplement_1\/i80\/36455706\/euaa396.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,3,9]],"date-time":"2021-03-09T20:59:06Z","timestamp":1615323546000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/europace\/article\/23\/Supplement_1\/i80\/6158557"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,1]]},"references-count":23,"journal-issue":{"issue":"Supplement_1","published-online":{"date-parts":[[2021,3,4]]},"published-print":{"date-parts":[[2021,3,4]]}},"URL":"https:\/\/doi.org\/10.1093\/europace\/euaa396","relation":{},"ISSN":["1099-5129","1532-2092"],"issn-type":[{"value":"1099-5129","type":"print"},{"value":"1532-2092","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,3,1]]},"published":{"date-parts":[[2021,3,1]]}}}