Abstract
Computational cardiology is rapidly becoming the gold standard for innovative medical treatments and device development. Despite a worldwide effort in mathematical and computational modeling research, the complexity and intrinsic multiscale nature of the heart still limit our predictability power raising the question of the optimal modeling choice for large-scale whole-heart numerical investigations. We propose an extended numerical analysis among two different electrophysiological modeling approaches: a simplified phenomenological one and a detailed biophysical one. To achieve this, we considered three-dimensional healthy and infarcted swine heart geometries. Heterogeneous electrophysiological properties, fine-tuned DT-MRI -based anisotropy features, and non-conductive ischemic regions were included in a custom-built finite element code. We provide a quantitative comparison of the electrical behaviors during steady pacing and sustained ventricular fibrillation for healthy and diseased cases analyzing cardiac arrhythmias dynamics. Action potential duration (APD) restitution distributions, vortex filament counting, and pseudo-electrocardiography (ECG) signals were numerically quantified, introducing a novel statistical description of restitution patterns and ventricular fibrillation sustainability. Computational cost and scalability associated with the two modeling choices suggests that ventricular fibrillation signatures are mainly controlled by anatomy and structural parameters, rather than by regional restitution properties. Finally, we discuss limitations and translational perspectives of the different modeling approaches in view of large-scale whole-heart in silico studies.
Highlights
Recent developments in computational modeling of the heart’s bio-electrical activity have established the most highly detailed example of a virtual organ [1,2,3]
Action potential duration (APD) restitution curves were computed for the two electrophysiolgical models over four selected cardiac surfaces: epicardium (EPI), left ventricular endocardium (LV), right ventricular endocardium (RV), left ventricular mid-myocardium (LVMM)
Numerical analyses allowed us to build up probability distribution functions of APD restitution curves for four selected anatomical surfaces
Summary
Recent developments in computational modeling of the heart’s bio-electrical activity have established the most highly detailed example of a virtual organ [1,2,3] These advances are the result of the significant progress in cardiac cell modeling, corroborated with experimentation and clinical. Detailed cell models, with highly accurate and validated biophysical relationships representing the ground truth, have been incorporated to improve the physiological relevance of in silico cardiac predictions. These approaches may result computationally demanding, further requiring advanced optimization tools [17,18,19,20,21,22,23]. This is especially true in the study of abnormal electrical waves, e.g., ventricular tachycardia (VT) and ventricular fibrillation (VF), in healthy and diseased conditions [25,26]
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