Patient-specific Generation of the Purkinje Network Driven by Clinical Measurements: the Case of Pathological Propagations Series Mathematics and Statistics (ms): Patient-specific Generation of the Purkinje Network Driven by Clinical Measurements: the Case of Pathological Propagations

To describe the electrical activity of the left ventricle is necessary to take into account the Purkinje fibers, responsible for the fast and coordinate ventricular activation, and their interaction with the muscular propagation. The aim of this work is to propose a methodology for the generation of a patient-specific Purkinje network driven by clinical measurements of the activation times acquired during pathological propagations. In particular, we consider clinical data acquired on four subjects suffering from pathologies with different origins, from conduction problems in the muscle or in the Purkinje fibers to a pre-excitation ventricular syndrome. To assess the accuracy of the proposed method, we compare the results obtained by using the patient-specific Purkinje network with the ones obtained by using a not patient-specific network. The results showed that the mean absolute errors are reduced by a factor in the range 27%-54%, highlighting the importance of including a patient-specific Purkinje network in computational models.

[1]  A. Quarteroni,et al.  Thermodynamically consistent orthotropic activation model capturing ventricular systolic wall thickening in cardiac electromechanics , 2014 .

[2]  Frank Bogun,et al.  Role of Purkinje fibers in post-infarction ventricular tachycardia. , 2006, Journal of the American College of Cardiology.

[3]  Roy C. P. Kerckhoffs,et al.  Effects of biventricular pacing and scar size in a computational model of the failing heart with left bundle branch block , 2009, Medical Image Anal..

[4]  Roy C. P. Kerckhoffs,et al.  Patient-specific modeling of dyssynchronous heart failure: a case study. , 2011, Progress in biophysics and molecular biology.

[5]  Paul A. Iaizzo Handbook of Cardiac Anatomy, Physiology, and Devices , 2005 .

[6]  C. Tai,et al.  Accessory atrioventricular pathways with only antegrade conduction in patients with symptomatic Wolff-Parkinson-White syndrome. Clinical features, electrophysiological characteristics and response to radiofrequency catheter ablation. , 1997, European heart journal.

[7]  C. Vergara,et al.  Patient-specific computational generation of the Purkinje network driven by clinical measuraments , 2013 .

[8]  Hervé Delingette,et al.  Coupled personalization of cardiac electrophysiology models for prediction of ischaemic ventricular tachycardia , 2011, Interface Focus.

[9]  Shibaji Shome,et al.  Modelling passive cardiac conductivity during ischaemia , 2005, Medical and Biological Engineering and Computing.

[10]  R M Gulrajani,et al.  A computer heart model incorporating anisotropic propagation. IV. Simulation of regional myocardial ischemia. , 1996, Journal of electrocardiology.

[11]  A. Nogami,et al.  Purkinje‐related Arrhythmias Part II: Polymorphic Ventricular Tachycardia and Ventricular Fibrillation , 2011, Pacing and clinical electrophysiology : PACE.

[12]  Fabio Nobile,et al.  AN EFFECTIVE ALGORITHM FOR THE GENERATION OF PATIENT-SPECIFIC PURKINJE NETWORKS IN COMPUTATIONAL ELECTROCARDIOLOGY , 2013 .

[13]  P. Wach,et al.  Three-dimensional computer model of the entire human heart for simulation of reentry and tachycardia: Gap phenomenon and Wolff-Parkinson-White syndrome , 1991, Basic Research in Cardiology.

[14]  D. Durrer,et al.  Total Excitation of the Isolated Human Heart , 1970, Circulation.

[15]  Bjørn Fredrik Nielsen,et al.  Computing Ischemic Regions in the Heart With the Bidomain Model—First Steps Towards Validation , 2013, IEEE Transactions on Medical Imaging.

[16]  Andrew E Pollard,et al.  Conduction between isolated rabbit Purkinje and ventricular myocytes coupled by a variable resistance. , 1998, American journal of physiology. Heart and circulatory physiology.

[17]  Thom F. Oostendorp,et al.  Application of the fastest route algorithm in the interactive simulation of the effect of local ischemia on the ECG , 2008, Medical & Biological Engineering & Computing.

[18]  A. Panfilov,et al.  Modelling of the ventricular conduction system. , 2008, Progress in biophysics and molecular biology.

[19]  J Jalife,et al.  Purkinje-muscle reentry as a mechanism of polymorphic ventricular arrhythmias in a 3-dimensional model of the ventricles. , 1998, Circulation research.

[20]  Halina Dobrzynski,et al.  The anatomy of the cardiac conduction system , 2009, Clinical anatomy.

[21]  R. W. Joyner,et al.  Variations in the functional electrical coupling between the subendocardial Purkinje and ventricular layers of the canine left ventricle. , 1985, Circulation research.

[22]  B. Taccardi,et al.  Spread of excitation in 3-D models of the anisotropic cardiac tissue. II. Effects of fiber architecture and ventricular geometry. , 1998, Mathematical biosciences.

[23]  J. Stinstra,et al.  The Effect of Conductivity on ST-Segment Epicardial Potentials Arising from Subendocardial Ischemia , 2005, Annals of Biomedical Engineering.

[24]  Guido Gerig,et al.  User-guided 3D active contour segmentation of anatomical structures: Significantly improved efficiency and reliability , 2006, NeuroImage.

[25]  Hervé Delingette,et al.  Patient-specific Electromechanical Models of the Heart for the Prediction of Pacing Acute Effects in Crt: a Preliminary Clinical Validation , 2022 .

[26]  Robert Michael Kirby,et al.  Inverse electrocardiographic source localization of ischemia: An optimization framework and finite element solution , 2013, J. Comput. Phys..

[27]  Paul A. Iaizzo,et al.  Handbook of Cardiac Anatomy, Physiology, and Devices , 2005, Springer International Publishing.

[28]  Alejandro F. Frangi,et al.  Characterization and Modeling of the Peripheral Cardiac Conduction System , 2013, IEEE Transactions on Medical Imaging.

[29]  Hervé Delingette,et al.  Human Atlas of the Cardiac Fiber Architecture: Study on a Healthy Population , 2012, IEEE Transactions on Medical Imaging.

[30]  Alejandro F. Frangi,et al.  Effects of the Purkinje System and Cardiac Geometry on Biventricular Pacing: A Model Study , 2010, Annals of Biomedical Engineering.

[31]  Ramesh M. Gulrajani,et al.  Computer Simulation of the Wolff-Parkinson-White Preexcitation Syndrome with a Modified Miller-Geselowitz Heart Model , 1986, IEEE Transactions on Biomedical Engineering.