Pezzuto Simone, Kal'avský Peter, Potse Mark, Prinzen Frits W, Auricchio Angelo, Krause Rolf
Center for Computational Medicine in CardiologyLugano, Switzerland.
Faculty of Informatics, Institute of Computational Science, Università della Svizzera ItalianaLugano, Switzerland.
Front Physiol. 2017 May 2;8:265. doi: 10.3389/fphys.2017.00265. eCollection 2017.
State-of-the-art cardiac electrophysiology models that are able to deliver physiologically motivated activation maps and electrocardiograms (ECGs) can only be solved on high-performance computing architectures. This makes it nearly impossible to adopt such models in clinical practice. ECG imaging tools typically rely on simplified models, but these neglect the anisotropic electric conductivity of the tissue in the forward problem. Moreover, their results are often confined to the heart-torso interface. We propose a forward model that fully accounts for the anisotropic tissue conductivity and produces the standard 12-lead ECG in a few seconds. The activation sequence is approximated with an eikonal model in the 3d myocardium, while the ECG is computed with the lead-field approach. Both solvers were implemented on graphics processing units and massively parallelized. We studied the numerical convergence and scalability of the approach. We also compared the method to the bidomain model in terms of ECGs and activation maps, using a simplified but physiologically motivated geometry and 6 patient-specific anatomies. The proposed methods provided a good approximation of activation maps and ECGs computed with a bidomain model, in only a few seconds. Both solvers scaled very well to high-end hardware. These methods are suitable for use in ECG imaging methods, and may soon become fast enough for use in interactive simulation tools.
能够生成具有生理意义的激活图和心电图(ECG)的先进心脏电生理模型只能在高性能计算架构上求解。这使得在临床实践中几乎不可能采用此类模型。ECG成像工具通常依赖简化模型,但这些模型在正向问题中忽略了组织的各向异性电导率。此外,它们的结果通常局限于心脏 - 躯干界面。我们提出了一种正向模型,该模型充分考虑了各向异性组织电导率,并能在几秒钟内生成标准的12导联ECG。在三维心肌中用程函模型近似激活序列,同时用导联场方法计算ECG。两个求解器都在图形处理单元上实现并进行了大规模并行化。我们研究了该方法的数值收敛性和可扩展性。我们还使用简化但具有生理意义的几何形状和6个患者特异性解剖结构,在ECG和激活图方面将该方法与双域模型进行了比较。所提出的方法仅需几秒钟就能很好地近似用双域模型计算得到的激活图和ECG。两个求解器在高端硬件上的扩展性都非常好。这些方法适用于ECG成像方法,并且可能很快就会快到足以用于交互式模拟工具。