Characterization and modeling of the peripheral cardiac conduction system.

The development of biophysical models of the heart has the potential to get insights in the patho-physiology of the heart, which requires to accurately modeling anatomy and function. The electrical activation sequence of the ventricles depends strongly on the cardiac conduction system (CCS). Its morphology and function cannot be observed in vivo, and therefore data available come from histological studies. We present a review on data available of the peripheral CCS including new experiments. In order to build a realistic model of the CCS we designed a procedure to extract morphological characteristics of the CCS from stained calf tissue samples. A CCS model personalized with our measurements has been built using L-systems. The effect of key unknown parameters of the model in the electrical activation of the left ventricle has been analyzed. The CCS models generated share the main characteristics of observed stained Purkinje networks. The timing of the simulated electrical activation sequences were in the physiological range for CCS models that included enough density of PMJs. These results show that this approach is a potential methodology for collecting knowledge-domain data and build improved CCS models of the heart automatically.

Construction of a computational anatomical model of the peripheral cardiac conduction system.

A methodology is presented here for automatic construction of a ventricular model of the cardiac conduction system (CCS), which is currently a missing block in many multiscale cardiac electromechanic models. It includes the His bundle, left bundle branches, and the peripheral CCS. The algorithm is fundamentally an enhancement of a rule-based method known as the Lindenmayer systems (L-systems). The generative procedure has been divided into three consecutive independent stages, which subsequently build the CCS from proximal to distal sections. Each stage is governed by a set of user parameters together with anatomical and physiological constrains to direct the generation process and adhere to the structural observations derived from histology studies. Several parameters are defined using statistical distributions to introduce stochastic variability in the models. The CCS built with this approach can generate electrical activation sequences with physiological characteristics.

Flexible modeling for anatomically-based cardiac conduction system construction.

We present a method to automatically deploy the peripheral section of the cardiac conduction system in ventricles. The method encodes anatomical information thorough rules that ensure that Purkinje network structures generated are realistic and comparable to those observed in ex-vivo studies. The core methodology is based in non-deterministic production rules that are parameterized by means of statistical functions. Input parameters allow the construction of a great diversity of Purkinje structures that could be incorporated in fine element ventricular models to perform electrophysiology simulations. Resulting Purkinje trees show good geometrical approximations of Purkinje core network and bundles when compared to histological diagrams and do not require user interaction. Simulations carried out with these models result in activation sequences remarkably similar to micro-electrode electrical mapping studies.

Effects of the purkinje system and cardiac geometry on biventricular pacing: a model study.

Heart failure leads to gross cardiac structural changes. While cardiac resynchronization therapy (CRT) is a recognized treatment for restoring synchronous activation, it is not clear how changes in cardiac shape and size affect the electrical pacing therapy. This study used a human heart computer model which incorporated anatomical structures such as myofiber orientation and a Purkinje system (PS) to study how pacing affected failing hearts. The PS was modeled as a tree structure that reproduced its retrograde activation feature. In addition to a normal geometry, two cardiomyopathies were modeled: dilatation and hypertrophy. A biventricular pacing protocol was tested in the context of atrio-ventricular block. The contribution of the PS was examined by removing it, as well as by increasing endocardial conductivity. Results showed that retrograde conduction into the PS was a determining factor for achieving intraventricular synchrony. Omission of the PS led to an overestimate of the degree of electrical dyssynchrony while assessing CRT. The activation patterns for the three geometries showed local changes in the order of activation of the lateral wall in response to the same pacing strategy. These factors should be carefully considered when determining lead placement and optimizing device parameters in clinical practice.

Numerical calculation of the dielectric and electrokinetic properties of vesicle suspensions.

The dielectric and electrokinetic properties of aqueous suspensions of vesicles (unilamellar liposomes) are numerically calculated in the 1 Hz to 1 GHz frequency range using a network simulation method. The model consists of a conducting internal medium surrounded by an insulating membrane with fixed surface charges on both sides. Without an applied field, the internal medium is in electric equilibrium with the external one, so that it also bears a net volume charge. Therefore, in the presence of an applied ac field, there is fluid flow both in the internal and in the external media. The obtained results are qualitatively different from those corresponding to suspensions of charged homogeneous particles, mainly due to the existence of an additional length scale (the membrane thickness) and the corresponding dispersion mechanism, charging of the membrane. Because of this dispersion, the shapes of the spectra change with the size of the particles (at constant zeta potential and particle radius to Debye length ratio) instead of merely shifting along the frequency axis. A comparison between the numerical results and those obtained using approximate analytical expressions shows deviations that are, in general, sufficiently large enough to show the necessity to use numerical results in order to interpret broad frequency range dielectric and electrokinetic measurements of vesicle suspensions.