Computational models of ventricular arrhythmia mechanisms: recent developments and future prospects

Clayton, Richard H.; Bishop, Martin J.

doi:10.1016/j.ddmod.2014.04.002

Cited by 10 publications

(8 citation statements)

References 55 publications

(59 reference statements)

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“…Recent technological advances in recording techniques 11 , 21 along with increasingly detailed models of cardiac electrophysiology 5 have greatly added to our knowledge of the mechanisms that initiate and sustain VF in the human heart. However, a detailed understanding of these mechanisms remains elusive.…”

Section: Introductionmentioning

confidence: 99%

Spatio-temporal Organization During Ventricular Fibrillation in the Human Heart

Robson

Aram

Nash³

et al. 2018

Ann Biomed Eng

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In this paper, we present a novel approach to quantify the spatio-temporal organization of electrical activation during human ventricular fibrillation (VF). We propose three different methods based on correlation analysis, graph theoretical measures and hierarchical clustering. Using the proposed approach, we quantified the level of spatio-temporal organization during three episodes of VF in ten patients, recorded using multi-electrode epicardial recordings with 30 s coronary perfusion, 150 s global myocardial ischaemia and 30 s reflow. Our findings show a steady decline in spatio-temporal organization from the onset of VF with coronary perfusion. We observed transient increases in spatio-temporal organization during global myocardial ischaemia. However, the decline in spatio-temporal organization continued during reflow. Our results were consistent across all patients, and were consistent with the numbers of phase singularities. Our findings show that the complex spatio-temporal patterns can be studied using complex network analysis.

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Section: Introductionmentioning

confidence: 99%

Spatio-temporal Organization During Ventricular Fibrillation in the Human Heart

Robson

Aram

Nash³

et al. 2018

Ann Biomed Eng

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“…; Boyle et al . , ; Clayton & Bishop, ; Trayanova & Boyle, ) and mechanical (Gurev et al . , ; Nordsletten et al .…”

Section: Introductionmentioning

confidence: 99%

“…Similarly, cell mechanics (myofilament) models (reviewed in Trayanova & Rice, 2011) have enabled the assembly of coupled electromechanical models of the heart. Such developments have helped to fuel the exciting progress made in simulating cardiac electrical (McDowell et al 2011;Moreno et al 2011;Relan et al 2011;Tandri et al 2011;Trayanova et al 2012;Boyle et al 2013Boyle et al , 2014Clayton & Bishop, 2014; and mechanical (Gurev et al 2011(Gurev et al , 2015Nordsletten et al 2011;Land et al 2012;Hu et al 2013aHu et al ,b, 2014Krishnamurthy et al 2013;Tobon-Gomez et al 2013;Fritz et al 2014;Lim et al 2015) behaviour at the organ level. Importantly, the emergent, integrative behaviours in the heart uncovered by these modelling studies have demonstrated how they result from complex interactions not only within a specific structural level but also from feed-forward and feedback interactions that connect a broad range of hierarchical levels of biological organization, further underscoring the importance of integrative research in heart (dys)function.…”

Section: Introductionmentioning

confidence: 99%

How computer simulations of the human heart can improve anti‐arrhythmia therapy

Trayanova

Chang

2016

The Journal of Physiology

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Over the last decade, the state-of-the-art in cardiac computational modelling has progressed rapidly. The electrophysiological function of the heart can now be simulated with a high degree of detail and accuracy, opening the doors for simulation-guided approaches to anti-arrhythmic drug development and patient-specific therapeutic interventions. In this review, we outline the basic methodology for cardiac modelling, which has been developed and validated over decades of research. In addition, we present several recent examples of how computational models of the human heart have been used to address current clinical problems in cardiac electrophysiology. We will explore the use of simulations to improve anti-arrhythmic pacing and defibrillation interventions; to predict optimal sites for clinical ablation procedures; and to aid in the understanding and selection of arrhythmia risk markers. Together, these studies illustrate how the tremendous advances in cardiac modelling are poised to revolutionize medical treatment and prevention of arrhythmia.

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“…4,7 Here, we review the important aspects of the electrophysiological functioning of the infarcted area (both the PZ and scar core) and discuss how these functional properties have been represented within previous computational models of IHD. Such models are increasingly being used to elucidate important mechanisms that underlie reentrant arrhythmias in the setting of structural heart disease, 10 helping understand and guide therapeutic interventions. In the second part of the paper, we highlight the potential differences in the overall electrophysiological function of this region, depending on the specific modeling representation.…”

Section: Introductionmentioning

confidence: 99%

Computational Representations of Myocardial Infarct Scars and Implications for Arrhythmogenesis

Connolly

Bishop

2016

Clin Med Insights Cardiol

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Image-based computational modeling is becoming an increasingly used clinical tool to provide insight into the mechanisms of reentrant arrhythmias. In the context of ischemic heart disease, faithful representation of the electrophysiological properties of the infarct region within models is essential, due to the scars known for arrhythmic properties. Here, we review the different computational representations of the infarcted region, summarizing the experimental measurements upon which they are based. We then focus on the two most common representations of the scar core (complete insulator or electrically passive tissue) and perform simulations of electrical propagation around idealized infarct geometries. Our simulations highlight significant differences in action potential duration and focal effective refractory period (ERP) around the scar, driven by differences in electrotonic loading, depending on the choice of scar representation. Finally, a novel mechanism for arrhythmia induction, following a focal ectopic beat, is demonstrated, which relies on localized gradients in ERP directly caused by the electrotonic sink effects of the neighboring passive scar.

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Computational models of ventricular arrhythmia mechanisms: recent developments and future prospects

Cited by 10 publications

References 55 publications

Spatio-temporal Organization During Ventricular Fibrillation in the Human Heart

Spatio-temporal Organization During Ventricular Fibrillation in the Human Heart

How computer simulations of the human heart can improve anti‐arrhythmia therapy

Computational Representations of Myocardial Infarct Scars and Implications for Arrhythmogenesis

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