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Conduction velocity in cardiac tissue is a crucial electrophysiological parameter for arrhythmia vulnerability. Pathologically reduced conduction velocity facilitates arrhythmogenesis because such conduction velocities decrease the wavelength with which re-entry may occur. Computational studies on CV and how it changes regionally in models at spatial scales multiple times larger than actual cardiac cells exist. However, microscopic conduction within cells and between them have been studied less in simulations. In this work, we study the relation of microscopic conduction patterns and clinically observable macroscopic conduction using an extracellular-membrane-intracellular model which represents cardiac tissue with these subdomains at subcellular resolution. By considering cell arrangement and non-uniform gap junction distribution, it yields anisotropic excitation propagation. This novel kind of model can for example be used to understand how discontinuous conduction on the microscopic level affects fractionation of electrograms in healthy and fibrotic tissue. Along the membrane of a cell, we observed a continuously propagating activation wavefront. When transitioning from one cell to the neighbouring one, jumps in local activation times occurred, which led to lower global conduction velocities than locally within each cell.
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.
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.