title: Computational generation of the Purkinje network driven by clinical measurements: the case of pathological propagations.
abstract: To properly describe the electrical activity of the left ventricle, it is necessary to model the Purkinje fibers, responsible for the fast and coordinate ventricular activation, and their interaction with the muscular propagation. The aim of this work is to propose a methodology for the generation of a patient-specific Purkinje network driven by clinical measurements of the activation times related to pathological propagations. In this case, one needs to consider a strongly coupled problem between the network and the muscle, where the feedback from the latter to the former cannot be neglected as in a normal propagation. We apply the proposed strategy to data acquired on three subjects, one of them suffering from muscular conduction problems owing to a scar and the other two with a muscular pre-excitation syndrome (Wolff-Parkinson-White). To assess the accuracy of the proposed method, we compare the results obtained by using the patient-specific Purkinje network generated by our strategy with the ones obtained by using a non-patient-specific network. The results show that the mean absolute errors in the activation time is reduced for all the cases, highlighting the importance of including a patient-specific Purkinje network in computational models.
authors.affiliation: Modellistica e Calcolo Scientifico (MOX), Dipartimento di Matematica, Politecnico di Milano, Milan, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Palamara
authors.forename: Christian
authors.initials: C
authors.lastname: Vergara
authors.forename: Domenico
authors.initials: D
authors.lastname: Catanzariti
authors.forename: Elena
authors.initials: E
authors.lastname: Faggiano
authors.forename: Cesarino
authors.initials: C
authors.lastname: Pangrazzi
authors.forename: Maurizio
authors.initials: M
authors.lastname: Centonze
authors.forename: Fabio
authors.initials: F
authors.lastname: Nobile
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Maines
authors.forename: Alfio
authors.initials: A
authors.lastname: Quarteroni
mesh_terms: D000368:Aged; D003198:Computer Simulation; D005260:Female; D006329:Heart Conduction System / Q000033:anatomy & histology / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D011690:Purkinje Fibers / Q000033:anatomy & histology / Q000502:physiology
keywords: Purkinje fibers; computational methods; eikonal equation; patient-specific electrical data