Key result
In 3D whole heart models of a human fetal heart, fiber anisotropy changed cardiac re-entry dynamics from persistent re-entry to rapid self-termination.
In a computational model of a human fetal heart, myocardial fiber anisotropy facilitated the rapid self-termination of cardiac re-entry, suggesting an anti-arrhythmic structural function during development.
Simulations of fetal re-entry warrant no clinical change; leaves open validation of geometry-driven termination in prospective studies.
The effect of human foetal heart geometry and anisotropy on anatomy induced drift and self-termination of cardiac re-entry is studied here in MRI based 2D slice and 3D whole heart computer simulations. Isotropic and anisotropic models of 20 weeks of gestational age human foetal heart obtained from 100μm voxel diffusion tensor MRI data sets were used in the computer simulations. The fiber orientation angles of the heart were obtained from the orientation of the DT-MRI primary eigenvectors. In a spatially homogeneous electrophysiological monodomain model with the DT-MRI based heart geometries, cardiac re-entry was initiated at a prescribed location in a 2D slice, and in the 3D whole heart anatomy models. Excitation was described by simplified FitzHugh-Nagumo kinetics. In a slice of the heart, with propagation velocity twice as fast along the fibres than across the fibers, DT-MRI based fiber anisotropy changes the re-entry dynamics from pinned to an anatomical re-entry. In the 3D whole heart models, the fiber anisotropy changes cardiac re-entry dynamics from a persistent re-entry to the re-entry self-termination. The self-termination time depends on the re-entry’s initial position. In all the simulations with the DT-MRI based cardiac geometry, the anisotropy of the myocardial tissue shortens the time to re-entry self-termination several folds. The numerical simulations depend on the validity of the DT-MRI data set used. The ventricular wall showed the characteristic transmural rotation of the helix angle of the developed mammalian heart, while the fiber orientation in the atria was irregular.
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Biktasheva et al. (2018) studied Cardiac arrhythmias (n=1). Anisotropic conduction model vs. Isotropic conduction model was evaluated on Cardiac re-entry self-termination. In 3D whole heart models of a human fetal heart, fiber anisotropy changed cardiac re-entry dynamics from persistent re-entry to rapid self-termination.
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