Abstract
Patient-specific cardiac models are now being used to guide therapies. The increased use of patient-specific cardiac simulations in clinical care will give rise to the development of virtual cohorts of cardiac models. These cohorts will allow cardiac simulations to capture and quantify inter-patient variability. However, the development of virtual cohorts of cardiac models will require the transformation of cardiac modelling from small numbers of bespoke models to robust and rapid workflows that can create large numbers of models. In this review, we describe the state of the art in virtual cohorts of cardiac models, the process of creating virtual cohorts of cardiac models, and how to generate the individual cohort member models, followed by a discussion of the potential and future applications of virtual cohorts of cardiac models.This article is part of the theme issue ‘Uncertainty quantification in cardiac and cardiovascular modelling and simulation’.
Highlights
How best to move from a cottage industry, where each model is handcrafted, to an industrialized process where models are produced en masse with limited to no human intervention, is a challenge. This white paper discusses the current state of patient-specific cardiac models; the process of developing virtual patient cohorts; how we validate these models; how we quantify uncertainty at the level of the individual model and at the level of the virtual cohort; and potential and future applications of virtual cohorts
The aim of virtual cohorts of cardiac models is to account for inter-patient variability in simulation studies
An advantage of the uncertainty quantification (UQ) approach is that it provides a natural framework for predictions: these are generated from multiple instances of the same patient, with parameters randomly sampled from the distributions in each simulation
Summary
This work has culminated in the recent use of models to guide therapies in prospective studies of ventricular tachycardia ablation [5], atrial fibrillation ablation [6] and cardiac resynchronization therapy lead positioning [7] This shift from developing research or proof-of-concept models to using models in clinical workflows requires a step change in speed and robustness in model creation [8]. How best to move from a cottage industry, where each model is handcrafted, to an industrialized process where models are produced en masse with limited to no human intervention, is a challenge This white paper discusses the current state of patient-specific cardiac models; the process of developing virtual patient cohorts; how we validate these models; how we quantify uncertainty at the level of the individual model and at the level of the virtual cohort; and potential and future applications of virtual cohorts
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