Name
Title | ||
|---|---|---|
3D Electrophysiological Modeling of Interstitial Fibrosis Networks and Their Role in Ventricular Arrhythmias in Non-Ischemic Cardiomyopathy |
Abstract | ||
|---|---|---|
<italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">Objective:</italic>
Interstitial fibrosis is a pathological expansion of the heart's inter-cellular collagen matrix. It is a potential complication of nonischemic cardiomyopathy (NICM), a class of diseases involving electrical and or mechanical dysfunction of cardiac tissue not caused by atherosclerosis. Patients with NICM and interstitial fibrosis often suffer from life threatening arrhythmias, which we aim to simulate in this study.
<italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">Methods:</italic>
Our methodology builds on an efficient discrete finite element (DFE) method which allows for the representation of fibrosis as infinitesimal splits in a mesh. We update the DFE method with a local connectivity analysis which creates a consistent topology in the fibrosis network. This is particularly important in nonischemic disease due to the potential presence of large and contiguous fibrotic regions and therefore potentially complex fibrosis networks.
<italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">Results:</italic>
In experiments with an image-based model, we demonstrate that our methodology is able to simulate reentrant electrical events associated with cardiac arrhythmias. These reentries depended crucially upon sufficient fibrosis density, which was marked by conduction slowing at high pacing rates. We also created a 2D test-case which demonstrated that fibrosis topologies can modulate transient conduction block, and thereby reentrant activations.
<italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">Conclusion:</italic>
Ventricular arrhythmias due to interstitial fibrosis in NICM can be efficiently simulated using our methods in medical image based geometries. Furthermore, fibrosis topology modulates transient conduction block, and should be accounted for in electrophysiological simulations with interstitial fibrosis.
<italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">Significance:</italic>
Our study provides methodology which has the potential to predict arrhythmias and to optimize treatments non-invasively for nonischemic cardiomyopathies. |
Year | DOI | Venue |
|---|---|---|
2020 | 10.1109/TBME.2020.2976924 | IEEE Transactions on Biomedical Engineering |
Keywords | DocType | Volume |
Three-dimensional displays,Diseases,Network topology,Topology,Two dimensional displays,Myocardium,Heart | Journal | 67 |
Issue | ISSN | Citations |
11 | 0018-9294 | 0 |
PageRank | References | Authors |
0.34 | 0 | 9 |
Name | Order | Citations | PageRank |
|---|---|---|---|
| Gabriel Balaban | 1 | 3 | 1.82 |
| Caroline Mendonça Costa | 2 | 10 | 4.59 |
| Bradley Porter | 3 | 0 | 0.34 |
| Brian Halliday | 4 | 0 | 0.68 |
| Christopher Aldo Rinaldi | 5 | 16 | 8.07 |
| Sanjay Prasad | 6 | 6 | 1.43 |
| G Plank | 7 | 201 | 33.05 |
| Tevfik F Ismail | 8 | 0 | 0.34 |
| Martin J. Bishop | 9 | 39 | 12.93 |