Personalizing Simulations of the Human Atria : Intracardiac Measurements, Tissue Conductivities, and Cellular Electrophysiology

This work addresses major challenges of heart model personalization. Analysis techniques for clinical intracardiac electrograms determine wave direction and conduction velocity from single beats. Electrophysiological measurements are simulated to validate the models. Uncertainties in tissue conductivities impact on simulated ECGs. A minimal model of cardiac myocytes is adapted to the atria. This makes personalized cardiac models a promising technique to improve treatment of atrial arrhythmias

Personalized noninvasive imaging of volumetric cardiac electrophysiology

Three-dimensionally distributed electrical functioning is the trigger of mechanical contraction of the heart. Disturbance of this electrical flow is known to predispose to mechanical catastrophe but, due to its amenability to certain intervention techniques, a detailed understanding of subject-specific cardiac electrophysiological conditions is of great medical interest. In current clinical practice, body surface potential recording is the standard tool for diagnosing cardiac electrical dysfunctions. However, successful treatments normally require invasive catheter mapping for a more detailed observation of these dysfunctions. In this dissertation, we take a system approach to pursue personalized noninvasive imaging of volumetric cardiac electrophysiology. Under the guidance of existing scientific knowledge of the cardiac electrophysiological system, we extract the subject specific cardiac electrical information from noninvasive body surface potential mapping and tomographic imaging data of individual subjects. In this way, a priori knowledge of system physiology leads the physiologically meaningful interpretation of personal data; at the same time, subject-specific information contained in the data identifies parameters in individual systems that differ from prior knowledge. Based on this perspective, we develop a physiological model-constrained statistical framework for the quantitative reconstruction of the electrical dynamics and inherent electrophysiological property of each individual cardiac system. To accomplish this, we first develop a coupled meshfree-BE (boundary element) modeling approach to represent existing physiological knowledge of the cardiac electrophysiological system on personalized heart-torso structures. Through a state space system approach and sequential data assimilation techniques, we then develop statistical model-data coupling algorithms for quantitative reconstruction of volumetric transmembrane potential dynamics and tissue property of 3D myocardium from body surface potential recoding of individual subjects. We also introduce a data integration component to build personalized cardiac electrophysiology by fusing tomographic image and BSP sequence of the same subject. In addition, we develop a computational reduction strategy that improves the efficiency and stability of the framework. Phantom experiments and real-data human studies are performed for validating each of the framework’s major components. These experiments demonstrate the potential of our framework in providing quantitative understanding of volumetric cardiac electrophysiology for individual subjects and in identifying latent threats in individual’s heart. This may aid in personalized diagnose, treatment planning, and fundamentally, prevention of fatal cardiac arrhythmia