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Heart Model Devised to Implant Child’s Defibrillator

Natalia Trayanova

Natalia Trayanova (Johns Hopkins University)

Engineers and medical researchers at Johns Hopkins University in Baltimore developed a three-dimensional computer model of a child’s heart to guide the optimal location for a defibrillator that regulates heart rhythms. The team led by biomedical engineering professor Natalia Trayanova describes the model online in The Journal of Physiology (paid subscription required).

Children born with abnormally small or malformed hearts have few options for treating their conditions, including the use of defibrillators that send electric impulses to regulate heart rhythms, but are generally designed for adults or children with normal-sized hearts. The usual method in these cases is to place the defribrillator outside the child’s body, but in this configuration, the devices sometimes fire at the wrong times, either when not needed or failing to fire when needed.  The impulses can also be too strong and painful to the child.

Trayanova and colleagues aimed to provide clinicians with a tool to determine the best location for placing a defribrillator internally in a child with this condition. That optimal location would best reset the child’s heart rhythms, while delivering the least amount of energy and gentlest shock, two factors that make it less painful for the patient and also extend the battery life.

The Johns Hopkins researchers developed the model from low-resolution magnetic resonance image (MRI) heart scans, in this case from a child born without tricuspid valve and right ventricle. The tricuspid valve normally connects the right atrium and right ventricle, and directs the flow of blood from the right atrium to the ventricle.  From the MRI scans, the team built a 3-D computer model of the heart that simulated the child’s dangerously weak and irregular heart rhythms.

The model offers representations of the patient’s heart muscle  fiber and connective tissue, down to ceullular and sub-cellular levels. The model also covers the patient’s torso surrounding the heart, including lungs, bones, and fat.

With the model, the researchers simulated placing a defribrillator at 11 different positions in this patient. Based on the simulations, they found two locations for the device with the lowest defibrillation charges needed to regulate the child’s heart rhythms. The team plans further tests of the model’s potential to help children born with heart defects.

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