title: Fast multiscale modeling of cardiac electrophysiology including Purkinje system.
abstract: In this paper, we present a modeling methodology to couple the cardiac conduction system to cardiac myocytes through a model of Purkinje-ventricular junctions to yield fast and realistic electrical activation of the ventricles. A patient-specific biventricular geometry is obtained from processing computed tomography scan data. A one-manifold implementation of the fast marching method based on Eikonal-type equations is used for modeling heart electrophysiology, which facilitates the multiscale 1-D-3-D coupling at very low computational costs. The method is illustrated in in-silico experiments where we analyze and compare alternative pacing strategies on the same patient-specific anatomy. We also show very good agreement between the results from the proposed approach and more detailed and comprehensive biophysical models for modeling cardiac electrophysiology. The effect of atrioventricular delay on the distribution of activation time in myocardium is studied with two experiments. Given the reasonable computational times and realistic activation sequences provided by our method, it can have an important clinical impact on the selection of optimal implantation sites of pacing leads or placement of ablation catheter's tip in the context of cardiac rhythm management therapies.
authors.affiliation: Department of Information and Communication Technologies, Center for Computational Imaging and Simulation Technologies in Biomedicine, Universitat Pompeu Fabra, Barcelona 08018, Spain. ali.pashaei@upf.edu
authors.forename: Ali
authors.initials: A
authors.lastname: Pashaei
authors.forename: Daniel
authors.initials: D
authors.lastname: Romero
authors.forename: Rafael
authors.initials: R
authors.lastname: Sebastian
authors.forename: Oscar
authors.initials: O
authors.lastname: Camara
authors.forename: Alejandro F
authors.initials: AF
authors.lastname: Frangi
mesh_terms: D004562:Electrocardiography / Q000379:methods*; D006329:Heart Conduction System / Q000033:anatomy & histology* / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D032383:Myocytes, Cardiac / Q000502:physiology; D011690:Purkinje Fibers / Q000033:anatomy & histology* / Q000502:physiology*; D014057:Tomography, X-Ray Computed