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  • A rule‐based method to mode...
    Doste, Ruben; Soto‐Iglesias, David; Bernardino, Gabriel; Alcaine, Alejandro; Sebastian, Rafael; Giffard‐Roisin, Sophie; Sermesant, Maxime; Berruezo, Antonio; Sanchez‐Quintana, Damian; Camara, Oscar

    International journal for numerical methods in biomedical engineering, April 2019, Letnik: 35, Številka: 4
    Journal Article

    Rule‐based methods are often used for assigning fiber orientation to cardiac anatomical models. However, existing methods have been developed using data mostly from the left ventricle. As a consequence, fiber information obtained from rule‐based methods often does not match histological data in other areas of the heart such as the right ventricle, having a negative impact in cardiac simulations beyond the left ventricle. In this work, we present a rule‐based method where fiber orientation is separately modeled in each ventricle following observations from histology. This allows to create detailed fiber orientation in specific regions such as the endocardium of the right ventricle, the interventricular septum, and the outflow tracts. We also carried out electrophysiological simulations involving these structures and with different fiber configurations. In particular, we built a modeling pipeline for creating patient‐specific volumetric meshes of biventricular geometries, including the outflow tracts, and subsequently simulate the electrical wavefront propagation in outflow tract ventricular arrhythmias with different origins for the ectopic focus. The resulting simulations with the proposed rule‐based method showed a very good agreement with clinical parameters such as the 10 ms isochrone ratio in a cohort of nine patients suffering from this type of arrhythmia. The developed modeling pipeline confirms its potential for an in silico identification of the site of origin in outflow tract ventricular arrhythmias before clinical intervention. We have developed a rule‐based method (RBM) that includes specific fiber orientation in different cardiac regions such as the right ventricle endocardium, the interventricular septum, and the outflow tracts, following observations from histological data. This adapted RBM allows running in silico simulations aimed to model pathologies where these regions are relevant such as outflow tract ventricular arrhythmias. The resulting simulations with the proposed RBM showed a very good agreement with clinical parameters.