SimICD: A Closed-Loop Simulation Framework For ICD Therapy

TL;DR

SimICD is a novel simulation framework that integrates ICD logic with cardiac electrophysiology models in a feedback loop, enabling realistic testing of ICD therapy protocols on virtual patients before clinical use.

Contribution

It introduces a closed-loop simulation tool combining device algorithms with cardiac models to simulate therapy decisions during arrhythmic episodes.

Findings

SimICD accurately replicates real ICD responses.

The framework allows reprogramming of ICD parameters.

It demonstrates realistic cardiac signal simulation.

Abstract

Virtual studies of ICD behaviour are crucial for testing device functionality in a controlled environment prior to clinical application. Although previous works have shown the viability of using in silico testing for diagnosis, there is a notable gap in available models that can simulate therapy progression decisions during arrhythmic episodes. This work introduces SimICD, a simulation tool which combines virtual ICD logic algorithms with cardiac electrophysiology simulations in a feedback loop, allowing the progression of ICD therapy protocols to be simulated for a range of tachy-arrhythmia episodes. Using a cohort of virtual patients, we demonstrate the ability of SimICD to simulate realistic cardiac signals and ICD responses that align with the logic of real-world devices, facilitating the reprogramming of ICD parameters to adapt to specific episodes.