Personalized Computer Models Developed for Heart Disease

(Gerd Altmann, Pixabay)

28 Nov. 2018. Researchers in the U.K. are developing computer models of heart functions that enable physicians to simulate recommended treatments for individual patients to gauge and optimize their outcomes. The first of these models, developed at Kings College London, tests the effects of catheter ablation, a widely used procedure to treat atrial fibrillation, a type of irregular heart rhythm.

Atrial fibrillation is a disorder where the atria, or upper chambers of the heart, beat irregularly instead of the normal, smooth regular beats that move blood effectively through the blood stream. Because of these irregular heart rhythms, blood can pool in the atria and form clots. If a clot should break off and flow to the brain, it can cause a stroke. American Heart Association estimates as many as 20 percent of people who have a stroke also have atrial fibrillation.

A team led by Kings College engineering professor Adelaide De Vecchi, a lecturer in computational cardiovascular modeling, aims to improve outcomes for catheter ablation, a common treatment for atrial fibrillation. With this procedure, a catheter is inserted through an artery or vein with a long flexible tube to the heart, to deliver heat from an energy source, such as an electrical current or radio-frequency waves, that scars the heart muscle responsible for the irregular heart beats, and return the heart to a normal rhythm. Unfortunately, the procedure is often not successful on the first try, requiring multiple attempts, due to patient-specific factors that are difficult to predict and quantify with current technologies.

To improve the odds for success with catheter ablation, De Vecchi and colleagues are identifying and quantifying the physiological and electrical factors making up heart rhythms, and constructing computational models for individual patients. These models aim to enable physicians to determine in advance the amounts of voltage needed to produce sufficient heat and time needed for the current to remain in contact with heart muscle to block the offending signals. The engineers are working with cardiac specialists at St. Thomas’ Hospital, a teaching hospital affiliated with Kings College London and a leading research and treatment center for irregular heart rhythms in the U.K., to develop and refine the models.

The initial project, now completed, was funded by a £93,400 ($US 120,000) award from the Engineering and Physical Sciences Research Council or EPSRC, one of the U.K.’s scientific funding agencies. The models are now being validated with clinical data from patients at St. Thomas’ Hospital. In an article accepted this month for publication in the journal Frontiers in Physiology, De Vecchi and colleagues report on tests of the personalized models with 2 patients having atrial fibrillation, which show their ability to predict performance of catheter ablation procedures, including factors such as catheter temperature and the patient’s heart structure.

De Vecchi notes in an EPSRC statement, “The really important thing is that these new personalized models show the heart working as a whole system. They allow different catheter ablation strategies to be assessed for each specific patient, for example, with regard to the precise area of the heart to target, and therefore enable the very best option to be pinpointed, maximizing the prospect of improving the patient’s quality of life.” She anticipates routine clinical use of the models within a decade.

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