Cobiveco: Consistent biventricular coordinates for precise and intuitive description of position in the heart – with MATLAB implementation

Schuler, Steffen; Pilia, Nicolas; Potyagaylo, Danila; Loewe, Axel

doi:10.1016/j.media.2021.102247

Cited by 27 publications

(16 citation statements)

References 24 publications

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“…Unfortunately, their simulated membrane voltages were not saved with the geometry and could not be consulted for comparison. In an attempt to reproduce their findings, we used the consistent biventricular coordinates system Cobiveco as published by Schuler et al ( 2021 ) to map our calculated membrane voltages to their deforming geometry. We then used what we presume was the pipeline used by Keller et al ( 2011 ) to do the forward calculation.…”

Section: Discussionmentioning

confidence: 99%

A Fully-Coupled Electro-Mechanical Whole-Heart Computational Model: Influence of Cardiac Contraction on the ECG

et al. 2021

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The ECG is one of the most commonly used non-invasive tools to gain insights into the electrical functioning of the heart. It has been crucial as a foundation in the creation and validation of in silico models describing the underlying electrophysiological processes. However, so far, the contraction of the heart and its influences on the ECG have mainly been overlooked in in silico models. As the heart contracts and moves, so do the electrical sources within the heart responsible for the signal on the body surface, thus potentially altering the ECG. To illuminate these aspects, we developed a human 4-chamber electro-mechanically coupled whole heart in silico model and embedded it within a torso model. Our model faithfully reproduces measured 12-lead ECG traces, circulatory characteristics, as well as physiological ventricular rotation and atrioventricular valve plane displacement. We compare our dynamic model to three non-deforming ones in terms of standard clinically used ECG leads (Einthoven and Wilson) and body surface potential maps (BSPM). The non-deforming models consider the heart at its ventricular end-diastatic, end-diastolic and end-systolic states. The standard leads show negligible differences during P-Wave and QRS-Complex, yet during T-Wave the leads closest to the heart show prominent differences in amplitude. When looking at the BSPM, there are no notable differences during the P-Wave, but effects of cardiac motion can be observed already during the QRS-Complex, increasing further during the T-Wave. We conclude that for the modeling of activation (P-Wave/QRS-Complex), the associated effort of simulating a complete electro-mechanical approach is not worth the computational cost. But when looking at ventricular repolarization (T-Wave) in standard leads as well as BSPM, there are areas where the signal can be influenced by cardiac motion of the heart to an extent that should not be ignored.

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Section: Discussionmentioning

confidence: 99%

A Fully-Coupled Electro-Mechanical Whole-Heart Computational Model: Influence of Cardiac Contraction on the ECG

et al. 2021

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“…We applied a rule-based method based on Bayer et al (2012) 1 to generate the local fiber and sheet architecture Q = { f 0 , s 0 , n 0 } of the myocardium with fiber angles of 60°at the endocardium and -60°at the epicardium ( Figure 1 ) in agreement with observations from diffusion tensor MRI of human hearts ( Lombaert et al, 2012 ). Furthermore, we computed ventricular coordinates according to Schuler et al (2021) and used them to separate the ventricle into the 17 segments classified by the American Heart Association (AHA; Cerqueira et al, 2002 ). The nine segments used by the NOGA XP system (Biosense Webster, Irvine, CA, United States) were defined equally.…”

Section: Methodsmentioning

confidence: 99%

Dyssynchronous Left Ventricular Activation is Insufficient for the Breakdown of Wringing Rotation

et al. 2022

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Cardiac resynchronization therapy is a valuable tool to restore left ventricular function in patients experiencing dyssynchronous ventricular activation. However, the non-responder rate is still as high as 40%. Recent studies suggest that left ventricular torsion or specifically the lack thereof might be a good predictor for the response of cardiac resynchronization therapy. Since left ventricular torsion is governed by the muscle fiber orientation and the heterogeneous electromechanical activation of the myocardium, understanding the relation between these components and the ability to measure them is vital. To analyze if locally altered electromechanical activation in heart failure patients affects left ventricular torsion, we conducted a simulation study on 27 personalized left ventricular models. Electroanatomical maps and late gadolinium enhanced magnetic resonance imaging data informed our in-silico model cohort. The angle of rotation was evaluated in every material point of the model and averaged values were used to classify the rotation as clockwise or counterclockwise in each segment and sector of the left ventricle. 88% of the patient models (n = 24) were classified as a wringing rotation and 12% (n = 3) as a rigid-body-type rotation. Comparison to classification based on in vivo rotational NOGA XP maps showed no correlation. Thus, isolated changes of the electromechanical activation sequence in the left ventricle are not sufficient to reproduce the rotation pattern changes observed in vivo and suggest that further patho-mechanisms are involved.

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“…The external stimulus I ext (x, t) is applied at the junction of the right atrial appendage and the superior vena cava [34] to initiate the depolarization wave in the atria. In the ventricles, we use consistent biventricular coordinates [35] to define seven positions (Table 1) that are known to be common sites of earliest activation [36,37]. To account for the conduction delay introduced by the atrioventricular node, the ventricles are stimulated 160 ms after the atria.…”

Section: Electrical Propagation Modelmentioning

confidence: 99%

“…Sites of earliest activation in terms of the coordinate system Cobiveco[35]: a apicobasal; m transmural; r rotational; v transventricular. δ m and δ rad are the transmural and radial extent of the activation site, respectively.…”

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confidence: 99%

The Impact of Standard Ablation Strategies for Atrial Fibrillation on Cardiovascular Performance in a Four-chamber Heart Model

Gerach¹,

Schuler²,

Wächter³

et al. 2022

Preprint

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Atrial fibrillation is one of the most frequent cardiac arrhythmias in the industrialized world and ablation therapy is the method of choice for many patients. However, ablation scars alter the electrophysiological activation and the mechanical behavior of the affected atria. Different ablation strategies with the aim to terminate atrial fibrillation and prevent its recurrence exist but their impact on the hemodynamic performance of the heart has not been investigated thoroughly. Methods: In this work, we present a simulation study analyzing five commonly used ablation scar patterns and their combinations in the left atrium regarding their impact on the pumping function of the heart using an electromechanical whole-heart model. We analyzed how the altered atrial activation and increased stiffness due to the ablation scar affect atrial as well as ventricular contraction and relaxation. Results: We found that systolic and diastolic function of the left atrium is impaired by ablation scars and that the reduction of atrial stroke volume of up to 11.43% depends linearly on the amount of inactivated tissue. Consequently, the end-diastolic volume of the left ventricle, and thus stroke volume, was reduced by up to 1.4% and 1.8%, respectively. During ventricular systole, left atrial pressure was increased by up to 20% due to changes in the atrial activation sequence and the stiffening of scar tissue. Conclusion:This study provides biomechanical evidence that atrial ablation has acute effects not only on atrial contraction but also on ventricular pumping function. Our results have the potential to help tailoring ablation strategies towards minimal global hemodynamic impairment.

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Cobiveco: Consistent biventricular coordinates for precise and intuitive description of position in the heart – with MATLAB implementation

Cited by 27 publications

References 24 publications

A Fully-Coupled Electro-Mechanical Whole-Heart Computational Model: Influence of Cardiac Contraction on the ECG

A Fully-Coupled Electro-Mechanical Whole-Heart Computational Model: Influence of Cardiac Contraction on the ECG

Dyssynchronous Left Ventricular Activation is Insufficient for the Breakdown of Wringing Rotation

The Impact of Standard Ablation Strategies for Atrial Fibrillation on Cardiovascular Performance in a Four-chamber Heart Model

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