An eikonal model with re-excitability for fast simulations in cardiac electrophysiology

TL;DR

This paper introduces an enhanced eikonal model incorporating re-excitability to accurately and efficiently simulate complex cardiac arrhythmias, potentially enabling real-time clinical applications.

Contribution

The authors develop a novel eikonal model that includes tissue re-excitability, extending its capability to simulate re-entrant arrhythmias in cardiac tissue.

Findings

Qualitatively accurate in simulating re-entries

Handles tissue anisotropy and heterogeneity

Potential for real-time simulation

Abstract

Precision cardiology based on cardiac digital twins requires accurate simulations of cardiac arrhythmias. However, detailed models, such as the monodomain model, are computationally costly and have limited applicability in practice. Thus, it desirable to have fast models that can still represent the main physiological features presented during cardiac arrhythmias. The eikonal model is an approximation of the monodomain model that is widely used to describe the arrival times of the electrical wave. However, the standard eikonal model does not generalize to the complex re-entrant dynamics that characterize the cardiac arrhythmias. In this work, we propose an eikonal model that includes the tissue re-excitability, which allows to describe re-entries. The re-excitability properties are inferred from the monodomain model. Our eikonal model also handles the tissue anisotropy and heterogeneity. We compare the eikonal model to the monodomain model in various numerical experiments in the atria and the ventricles. The eikonal model is qualitatively accurate in the simulation of re-entries and can be potentially ran in real-time, opening the door to its clinical applicability.