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Journal of Translational Medicine

, 14:147

Cardiovascular, Metabolic and Lipoprotein Translation


BackgroundIntegration of whole-heart activation simulations and inverse potential mapping IPM could benefit the guidance and planning of electrophysiological procedures. Routine clinical application requires a fast and adaptable workflow. These requirements limit clinical translation of existing simulation models. This study proposes a comprehensive finite element model FEM based whole-heart computational workflow suitable for IPM and simulations.

MethodsThree volunteers and eight patients with premature ventricular contractions underwent body surface potential BSP acquisition followed by a cardiac MRI CMR scan. The cardiac volumes were segmented from the CMR images using custom written software. The feasibility to integrate tissue-characteristics was assessed by generating meshes with virtual edema and scar. Isochronal activation maps were constructed by identifying the fastest route through the cardiac volume using the Möller–Trumbore and Floyd–Warshall algorithms. IPM’s were reconstructed from the BSP’s.

ResultsWhole-heart computational meshes were generated within seconds. The first point of atrial activation on IPM was located near the crista terminalis of the superior vena cave into the right atrium. The IPM demonstrated the ventricular epicardial breakthrough at the attachment of the moderator band with the right ventricular free wall. Simulations of sinus rhythm were successfully performed. The conduction through the virtual edema and scar meshes demonstrated delayed activation or a complete conductional block respectively.

ConclusionThe proposed FEM based whole-heart computational workflow offers an integrated platform for cardiac electrical assessment using simulations and IPM. This workflow can incorporate patient-specific electrical parameters, perform whole-heart cardiac activation simulations and accurately reconstruct cardiac activation sequences from BSP’s.

KeywordsPersonalized cardiac model Whole-heart simulation Whole-heart inverse potential mapping FEM based cardiac simulations Patient-specific therapy Electronic supplementary materialThe online version of this article doi:10.1186-s12967-016-0902-0 contains supplementary material, which is available to authorized users.

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Author: P. Bhagirath - A. W. M. van der Graaf - J. de Hooge - N. M. S. de Groot - M. J. W. Götte


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