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Efficient numerical methods for simulating cardiac electrophysiology with cellular resolution
(2023)
The cardiac extracellular-membrane-intracellular (EMI) model enables the precise geometrical representation and resolution of aggregates of individual myocytes. As a result, it not only yields more accurate simulations of cardiac excitation compared to homogenized models but also presents the challenge of solving much larger problems. In this paper, we introduce recent advancements in three key areas: (i) the creation of artificial, yet realistic grids, (ii) efficient higher-order time stepping achieved by combining low-overhead spatial adaptivity on the algebraic level with progressive spectral deferred correction methods, and (iii) substructuring domain decomposition preconditioners tailored to address the complexities of heterogeneous problem structures. The efficiency gains of these proposed methods are demonstrated through numerical results on cardiac meshes of different sizes.
Aims. Detection and quantification of myocardial scars are helpful both for diagnosis of heart diseases and for building personalized simulation models. Scar tissue is generally characterized by a different conduction of electrical excitation. We aim at estimating conductivity-related parameters from endocardial mapping data, in particular the conductivity tensor. Solving this inverse problem requires computationally expensive monodomain simulations on fine discretizations. Therefore, we aim at accelerating the estimation using a multilevel method combining electrophysiology models of different complexity, namely the monodomain and the eikonal model.
Methods. Distributed parameter estimation is performed by minimizing the misfit between simulated and measured electrical activity on the endocardial surface, subject to the monodomain model and regularization, leading to a constrained optimization problem. We formulate this optimization problem, including the modeling of scar tissue and different regularizations, and design an efficient iterative solver. We consider monodomain grid hierarchies and monodomain-eikonal model hierarchies in a recursive multilevel trust-region method.
Results. From several numerical examples, both the efficiency of the method and the estimation quality, depending on the data, are investigated. The multilevel solver is significantly faster than a comparable single level solver. Endocardial mapping data of realistic density appears to be just sufficient to provide quantitatively reasonable estimates of location, size, and shape of scars close to the endocardial surface.
Conclusion. In several situations, scar reconstruction based on eikonal and monodomain models differ significantly, suggesting the use of the more accurate but more expensive monodomain model for this purpose. Still, eikonal models can be utilized to accelerate the computations considerably, enabling the use of complex electrophysiology models for estimating myocardial scars from endocardial mapping data.
Cardiac electrograms are an important tool to study the spread of excitation waves inside the heart, which in turn underlie muscle contraction. Electrograms can be used to analyse the dynamics of these waves, e.g. in fibrotic tissue. In computational models, these analyses can be done with greater detail than during minimally invasive in vivo procedures. Whilst homogenised models have been used to study electrogram genesis, such analyses have not yet been done in cellularly resolved models. Such high resolution may be required to develop a thorough understanding of the mechanisms behind abnormal excitation patterns leading to arrhythmias. In this study, we derived electrograms from an excitation propagation simulation in the Extracellular, Membrane, Intracellular (EMI) model, which represents these three domains explicitly in the mesh. We studied the effects of the microstructural excitation dynamics on electrogram genesis and morphology. We found that electrograms are sensitive to the myocyte alignment and connectivity, which translates into micro-fractionations in the electrograms.