A rule-based method to model myocardial fiber orientation in cardiac biventricular geometries with outflow tracts
- Publication date
- Publisher
- Wiley
Abstract
Rule-based methods are often used for assigning fiber orientation to cardiac anatomical models. However, existing
methods have been developed using data mostly from the left ventricle. As a consequence, fiber information obtained
from rule-based methods often does not match histological data in other areas of the heart such as the right ventricle,
having a negative impact in cardiac simulations beyond the left ventricle. In this work, we present a rule-based method
where fiber orientation is separately modeled in each ventricle following observations from histology. This allows to
create detailed fiber orientation in specific regions such as the endocardium of the right ventricle, the interventricular
septum and the outflow tracts. We also carried out electrophysiological simulations involving these structures and
with different fiber configurations. In particular, we built a modelling pipeline for creating patient-specific volumetric
meshes of biventricular geometries, including the outflow tracts, and subsequently simulate the electrical wavefront
propagation in outflow tract ventricular arrhythmias with different origins for the ectopic focus. The resulting simulations
with the proposed rule-based method showed a very good agreement with clinical parameters such as the 10 ms
isochrone ratio in a cohort of nine patients suffering from this type of arrhythmia. The developed modelling pipeline
confirms its potential for an in silico identification of the site of origin in outflow tract ventricular arrhythmias before
clinical intervention.This work was partially funded by the European
Union under the Horizon 2020 Programme for Research,
Innovation (grant agreement No. 642676 CardioFunXion