Key result
The Eikonal model combined with the boundary element method yielded accurate local activation times and precise ECGs with correlation coefficients >0.9 compared to full bidomain simulations.
Why the study?
The bidomain model and finite element method are computationally expensive standards for cardiac electrophysiology, making them suboptimal for fast and large-scale simulations.
Simulations of atrial LATs and ECGs can be notably accelerated to clinically feasible time frames at high accuracy by resorting to the Eikonal and boundary element methods.
May accelerate atrial electrophysiology simulations for research; leaves open human validation before clinical use.
OBJECTIVE: The bidomain model and the finite element method are an established standard to mathematically describe cardiac electrophysiology, but are both suboptimal choices for fast and large-scale simulations due to high computational costs. We investigate to what extent simplified approaches for propagation models (monodomain, reaction-Eikonal and Eikonal) and forward calculation (boundary element and infinite volume conductor) deliver markedly accelerated, yet physiologically accurate simulation results in atrial electrophysiology. METHODS: We compared action potential durations, local activation times (LATs), and electrocardiograms (ECGs) for sinus rhythm simulations on healthy and fibrotically infiltrated atrial models. RESULTS: All simplified model solutions yielded LATs and P waves in accurate accordance with the bidomain results. Only for the Eikonal model with pre-computed action potential templates shifted in time to derive transmembrane voltages, repolarization behavior notably deviated from the bidomain results. ECGs calculated with the boundary element method were characterized by correlation coefficients 0.9 compared to the finite element method. The infinite volume conductor method led to lower correlation coefficients caused predominantly by systematic overestimations of P wave amplitudes in the precordial leads. CONCLUSION: Our results demonstrate that the Eikonal model yields accurate LATs and combined with the boundary element method precise ECGs compared to markedly more expensive full bidomain simulations. However, for an accurate representation of atrial repolarization dynamics, diffusion terms must be accounted for in simplified models. SIGNIFICANCE: Simulations of atrial LATs and ECGs can be notably accelerated to clinically feasible time frames at high accuracy by resorting to the Eikonal and boundary element methods.
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Nagel et al. (2022) studied Atrial electrophysiology (in silico model). Simplified propagation models (monodomain, reaction-Eikonal, Eikonal) and forward calculation methods (boundary element, infinite volume conductor) vs. Bidomain model and finite element method was evaluated on Accuracy of local activation times (LATs), action potential durations (APDs), and electrocardiograms (ECGs). The Eikonal model combined with the boundary element method yielded accurate local activation times and precise ECGs with correlation coefficients >0.9 compared to full bidomain simulations.
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