The effect of simplifying assumptions in the bidomain model of cardiac tissue: application to ST segment shifts during partial ischaemia

In this study various electrical conductivity approximations used in bidomain models of cardiac tissue are considered. Comparisons are based on epicardial surface potential distributions arising from regions of subendocardial ischaemia situated within the cardiac tissue. Approximations studied are a single conductivity bidomain model, an isotropic bidomain model and equal and reciprocal anisotropy ratios both with and without fibre rotation. It is demonstrated both analytically and numerically that the approximations involving a single conductivity bidomain, an isotropic bidomain or equal anisotropy ratios (ignoring fibre rotation) results in identical epicardial potential distributions for all degrees of subendocardial ischaemia. This result is contrary to experimental observations. It is further shown that by assuming reciprocal anisotropy ratios, epicardial potential distributions vary with the degree of subendocardial ischaemia. However, it is concluded that unequal anisotropy ratios must be used to obtain the true character of experimental observations.     

A sensitivity study of conductivity values in the passive bidomain equation

There is a complex interplay between the four conductivity values used in the bidomain equation and the resulting electric potential distribution in cardiac tissue arising from subendocardial ischaemia. Based on the three commonly used experimentally derived conductivity data sets, a non-dimensional formulation of the passive bidomain equation is derived, which gives rise naturally to several dimensionless conductivity ratios. The data sets are then used to define a parameter space of these ratios, which is studied by considering the correlation coefficients between different epicardial potential distributions.From this study, it is shown that the ratio of the intracellular longitudinal conductivity to the intracellular transverse conductivity is the key parameter in explaining the differences between the epicardial potential distributions observed with these three data sets.     

The effect of boundary conditions on epicardial potential distributions

This study presents a comparison of semi-analytical and numerical solution techniques for solving the passive bidomain equation in simple tissue geometries containing a region of subendocardial ischaemia. When the semi-analytical solution is based on Fourier transforms, recovering the solution from the frequency domain via fast Fourier transforms imposes a periodic boundary condition on the solution of the partial differential equation. On the other hand, the numerical solution uses an insulation boundary condition. When these techniques are applied to calculate the epicardial surface potentials, both yield a three well potential distribution which is identical if fibre rotation within the tissue is ignored. However, when fibre rotation is included, the resulting three-well distribution rotates, but through different angles, depending on the solution method. A quantitative comparison between the semi-analytical and numerical solutiontechniques is presented in terms of the effect fibre rotation has on the rotation of the epicardial potential distribution. It turns out that the Fourier transform approach predicts a larger rotation of the epicardial potential distribution than the numerical solution. The conclusion from this study is that it is not always possible to use analytical or semi-analytical solutions to check the accuracy of numerical solution procedures. For the problem considered here, this checking is only possible when it is assumed that there is no fibre rotation through the tissue.     

A finite volume method solution for the bidomain equations and their application to modelling cardiac ischaemia

This paper presents an implementation of the finite volume method with the aim of studying subendocardial ischaemia during the ST segment. In this implementation, based on hexahedral finite volumes, each quadrilateral sub-face is split into two triangles to improve the accuracy of the numerical integration in complex geometries and when fibre rotation is included. The numerical method is validated against previously published solutions obtained from slab and cylindrical models of the left ventricle with subendocardial ischaemia and no fibre rotation. Epicardial potential distributions are then obtained for a half-ellipsoid model of the left ventricle. In this case it is shown that for isotropic cardiac tissue the degree of subendocardial ischaemia does not affect the epicardial potential distribution, which is consistent with previous findings from analytical studies in simpler geometries. The paper also considers the behaviour of various preconditioners for solving numerically the resulting system of algebraic equations resulting from the implementation of the finite volume method. It is observed that each geometry considered has its own optimal preconditioner.     

How ischaemic region shape affects ST potentials in models of cardiac tissue

This numerical study uses a simple bidomain model of cardiac tissue to compare the effect of three different ischaemic region geometries (rectangular, cylindrical and semi-ellipsoidal) on the extracellular epicardial potentials during the ST segment. Results are obtained using anisotropic conductivities based on experimentally derived data. The model is then altered, to include heterogeneous conductivities in the ischaemic region and larger border zone widths, in order to better reproduce realistic scenarios. Initial results for the rectangular and cylindrical ischaemic shapes show a central depression over the ischaemic region, for low ischaemic thicknesses, which separates into three depressions as the ischaemic thickness increases. For ischaemic thicknesses above 70% an elevation appears over the ischaemic region and this increases in magnitude as the ischaemia becomes transmural. Results for the semi-ellipsoidal shape, however, differ, with the central depression separating into only two depressions as the thickness increases. Changing the conductivity inside the ischaemic region significantly affects results for each geometry, with depression staying over the ischaemic region for much higher levels of ischaemia (up to 90% thickness). Increasing the intramural border zone thickness did not significantly affect the epicardial potential distributions.     

心肌透壁缺血时心脏表面心电图ST段位移的仿真研究

利用心肌的双域模型计算机模拟了不同区域心肌透壁缺血时ＳＴ 段位移在心脏表面的分布,发现心脏表面ＳＴ 段位移的分布式样和缺血区域大小有关,一个小面积的透壁缺血在缺血区上出现均匀分布的ＳＴ 段上升, 而在心脏表面的其他部位上几乎没有出现ＳＴ 段下降; 一个大面积的缺血像左降支或左旋支区域的缺血, ＳＴ 段位移在心脏表面的左侧区出现了一个偶极子式的分布,在缺血区为ＳＴ 段上升, 在正常区为ＳＴ 段下降, 并且其幅度随远离缺血边界而减小; 同时发现透壁缺血时的ＳＴ 段下降是缺血电流源的不可分割的一部分。 比较了这些模拟结果和在动物实验中所观察到的ＳＴ 段位移的变化,从而分析了本文得到的结论在临床上定位心肌缺血的指导意义。     

Validation of three-dimensional conduction models using experimental mapping: are we getting closer?

The anisotropic material properties, irregular geometry, and specialized conduction system of the heart all affect the three-dimensional (3D) spread of electrical activation. A limited number of research groups have tried accounting for these features in 3D conduction models to investigate more thoroughly their observations of cardiac electrical activity in 3D experimental preparations. The full potential of these large scale conduction models, however, has not been realized because of a lack of quantitative validation with experiment. Such validation is critical in order to use the models to predict the electrical response of the myocardium to drugs or electrical stimulation. In this paper, a quantitative, experimental validation of paced activation in a 3D conduction model of a 3 cm × 3 cm × 1 cm section of the ventricular wall is presented. Epicardial and intramural pacing stimuli were applied in the center of a 528 channel electrode plaque sutured to the left ventricle in dogs. Unipolar electrograms were recorded at 2 kHz during and after pacing. Fiber directions within the tissue below the electrodes were estimated histologically and from pace-mapping. Simulated epicardial electrograms were computed for surface paced beats using our 3D bidomain model of the mapped tissue volume incorporating the measured fiber directions. Extracellular potentials and isochronal maps resulting from paced activations in both model and experiment were directly compared. Preliminary results demonstrate that our 3D model reproduces qualitatively such key features of the experimental data as electrogram morphologies and epicardial conduction velocities. Though quantitative agreement between model and experiment was only moderate, the validation approach described herein is an essential first step in assessing the predictive capability of present day conduction models.     

A new approach to the determination of cardiac potential distributions: application to the analysis of electrode configurations

This paper presents a mathematical model and new solution technique for studying the electric potential in a slab of cardiac tissue. The model is based on the bidomain representation of cardiac tissue and also allows for the effects of fibre rotation between the epicardium and the endocardium. A detailed solution method, based on Fourier Series and a simple one-dimensional finite difference scheme, for the governing equations for electric potential in the tissue and the blood, is also presented. This method has the advantage that the potential can be calculated only at points where it is required, such as the measuring electrodes. The model is then used to study various electrode configurations which have been proposed to determine cardiac tissue conductivity parameters. Three electrode configurations are analysed in terms of electrode spacing, placement position and the effect of including fibre rotation: the usual surface four-electrode configuration; a single vertical analogue of this and a two probe configuration, which has the current electrodes on one probe and the measuring electrodes on the other, a fixed distance away. It is found that including fibre rotation has no effect on the potentials measured in the first two cases; however, in the two probe case, non-zero fibre rotation causes a significant drop in the voltage measured. This leads to the conclusion that it is necessary to include the effects of fibre rotation in any model which involves the use of multiple plunge electrodes.     

Electrically silent magnetic fields.

There has been a significant controversy over the past decade regarding the relative information content of bioelectric and biomagnetic signals. In this paper we present a new, theoretical example of an electrically-silent magnetic field, based on a bidomain model of a cylindrical strand of tissue generalized to include off-diagonal components in the conductivity tensors. The physical interpretation of the off-diagonal components is explained, and analytic expressions for the electrical potential and the magnetic field are found. These expressions show that information not obtainable from electrical potential measurements can be obtained from measurements of the magnetic field in systems with conductivity tensors more complicated than those previously examined.     

Modification of a cylindrical bidomain model for cardiac tissue.

Previous models based on a cylindrical bidomain assumed either that the ratio of intracellular and interstitial conductivities in the principal directions were the same or that there was no radial variation in potential (i.e., a planar front, delta Vm/delta rho = 0). This paper presents a formulation and the expressions for the intracellular, interstitial, extracellular, and transmembrane potentials arising from nonplanar propagation along a cylindrical bundle of cardiac tissue represented as a bidomain with arbitrary anisotropy. For unequal anisotropy, the transmembrane current depends not only on the local change of the transmembrane potential but also on the nature of the transmembrane potential throughout the volume.     

Modeling of IK1 mutations in human left ventricular myocytes and tissue

Elucidation of the cellular basis of arrhythmias in ion channelopathy disorders is complicated by the inherent difficulties in studying human cardiac tissue. Thus we used a computer modeling approach to study the mechanisms of cellular dysfunction induced by mutations in inward rectifier potassium channel (K(ir))2.1 that cause Andersen-Tawil syndrome (ATS). ATS is an autosomal dominant disorder associated with ventricular arrhythmias that uncommonly degenerate into the lethal arrhythmia torsade de pointes. We simulated the cellular and tissue effects of a potent disease-causing mutation D71V K(ir)2.1 with mathematical models of human ventricular myocytes and a bidomain model of transmural conduction. The D71V K(ir)2.1 mutation caused significant action potential duration prolongation in subendocardial, midmyocardial, and subepicardial myocytes but did not significantly increase transmural dispersion of repolarization. Simulations of the D71V mutation at shorter cycle lengths induced stable action potential alternans in midmyocardial, but not subendocardial or subepicardial cells. The action potential alternans was manifested as an abbreviated QRS complex in the transmural ECG, the result of action potential propagation failure in the midmyocardial tissue. In addition, our simulations of D71V mutation recapitulate several key ECG features of ATS, including QT prolongation, T-wave flattening, and QRS widening. Thus our modeling approach faithfully recapitulates several features of ATS and provides a mechanistic explanation for the low frequency of torsade de pointes arrhythmia in ATS.     

An approximate solution to the periodic bidomain equations in one dimension

An approximate, computationally tractable solution is proposed for the potentials in the bidomain model with periodic intracellular junctions (the periodic bidomain model). This new approach is based on the one-dimensional rigorous spectral method described previously by Trayanova and Pilkington (IEEE Trans. Biomed. Eng., May 1993). The total solution to the one-dimensional periodic bidomain problem is decomposed in the spectral domain into solutions to (1) the single-fiber classical bidomain problem in which the intracellular conductivity value incorporates the average contribution from cytoplasm and junction and (2) the “junctional” potential problem due to the presence of junctions at discrete locations alone. Solving for the junctional term rigorously requires most of the numerical effort in the solution for the periodic bidomain potentials. Here the junctional potential is found approximately with little numerical effort. A comparison between the rigorous and the approximate solutions serves as a justification for the proposed approximate solution procedure. The procedure outlined in this paper is applicable to higher spatial dimensions where both tissue anisotropy and junctional inhomogeneities play a role in establishing the transmembrane potential distribution.     

Epicardial coronary blood flow including the presence of stenoses and aorto-coronary bypasses--I: Model and numerical method

A computer model and numerical method for calculating left epicardial coronary blood flow has been developed. This model employs a finite-branching geometry of the coronary vasculature and the one-dimensional, unsteady equations for flow with friction. The epicardial coronary geometry includes the left main and its bifurcation, the left anterior descending and left circumflex coronary arteries, and a selected number of small branches. Each of the latter terminate in an impedance, whose resistive component is related to intramyocardial compression through a linear dependence on left ventricular pressure. The elastic properties of the epicardial arteries are taken to be non-linear and are prescribed by specifying the local small-disturbance wave speed. The model allows for the incorporation of multiple stenoses as well as aorto-coronary bypasses. Calculations using this model predict pressure and flow waveform development and allow for the systematic investigation of the dependence of coronary flow on various parameters, e.g., peripheral resistance, wall properties, and branching pattern, as well as the presence of stenoses and bypass grafts. Reasonable comparison between calculations and earlier experiments in horses has been obtained.     

An Analysis and Comparison of Convergence and Uniqueness of Time-Independent Bone Adaptation Models

A recently presented solution method for the bidomain model (Johnston et al. 2006), which involves the application of direct current for studying electrical potential in a slab of cardiac tissue, is extended here to allow the use of an applied alternating current. The advantage of using AC current, in a four-electrode method for determining cardiac conductivities, is that instead of using ‘close’ and ‘wide’ electrode spacings to make potential measurements, increasing the frequency of the AC current redirects a fraction of the current from the extracellular space into the intracellular space.

The model is based on the work of Le Guyader et al. (2001), but is able to include the effects of the fibre rotation between the epicardium and the endocardium on the potentials. Also, rather than using a full numerical technique, the solution method uses Fourier series and a simple one dimensional finite difference scheme, which has the advantage of allowing the potentials to be calculated only at points, such as the measuring electrodes, where they are required.

The new alternating current model, which includes intracellular capacitance, is used with a particular four-electrode configuration, to show that the potential measured is affected by changes in fibre rotation. This is significant because it indicates that it is necessary to include fibre rotation in models, which are to be used in conjunction with measuring arrays that are more complex than those involving simply surface probes or a single vertical probe.     

A solution method for the determination of cardiac potential distributions with an alternating current source

A recently presented solution method for the bidomain model (Johnston et al. 2006), which involves the application of direct current for studying electrical potential in a slab of cardiac tissue, is extended here to allow the use of an applied alternating current. The advantage of using AC current, in a four-electrode method for determining cardiac conductivities, is that instead of using 'close' and 'wide' electrode spacings to make potential measurements, increasing the frequency of the AC current redirects a fraction of the current from the extracellular space into the intracellular space. The model is based on the work of Le Guyader et al. (2001), but is able to include the effects of the fibre rotation between the epicardium and the endocardium on the potentials. Also, rather than using a full numerical technique, the solution method uses Fourier series and a simple one dimensional finite difference scheme, which has the advantage of allowing the potentials to be calculated only at points, such as the measuring electrodes, where they are required. The new alternating current model, which includes intracellular capacitance, is used with a particular four-electrode configuration, to show that the potential measured is affected by changes in fibre rotation. This is significant because it indicates that it is necessary to include fibre rotation in models, which are to be used in conjunction with measuring arrays that are more complex than those involving simply surface probes or a single vertical probe.     

Potential and current distributions in a cylindrical bundle of cardiac tissue.

The intracellular and interstitial potentials associated with each cell or fiber in multicellular preparations carrying a uniformly propagating wave are important for characterizing the electrophysiological behavior of the preparation and in particular, for evaluating the source contributed by each fiber. The aforementioned potentials depend on a number of factors including the conductivities characterizing the intracellular, interstitial, and extracellular domains, the thickness of the tissue, and the distance (depth) of the field point from the surface of the tissue. A model study is presented describing the extracellular and interstitial potential distribution and current flow in a cylindrical bundle of cardiac muscle arising from a planar wavefront. For simplicity, the bundle is considered as a bidomain. Using typical values of conductivity, the results show that the intracellular and interstitial potential of fibers near the center of a very large bundle (greater than 10 mm) may be approximated by the potentials of a single fiber surrounded by a limited extracellular space (a fiber in oil), hence justifying a core-conductor model. For smaller bundles, the peak interstitial potential is less than that predicted by the core-conductor model but still large enough to affect the overall source strength. The magnitude of the source strength is greatest for fibers lying near the center of the bundle and diminishes sharply for fibers within 50 microns of the surface.     

Virtual electrode polarization in the far field: implications for external defibrillation

We recently suggested that failure of implantable defibrillation therapy may be explained by the virtual electrode-induced phase singularity mechanism. The goal of this study was to identify possible mechanisms of vulnerability and defibrillation by externally applied shocks in vitro. We used bidomain simulations of realistic rabbit heart fibrous geometry to predict the passive polarization throughout the heart induced by external shocks. We also used optical mapping to assess anterior epicardium electrical activity during shocks in Langendorff-perfused rabbit hearts (n = 7). Monophasic shocks of either polarity (10-260 V, 8 ms, 150 microF) were applied during the T wave from a pair of mesh electrodes. Postshock epicardial virtual electrode polarization was observed after all 162 applied shocks, with positive polarization facing the cathode and negative polarization facing the anode, as predicted by the bidomain simulations. During arrhythmogenesis, a new wave front was induced at the boundary between the two regions near the apex but not at the base. It spread across the negatively polarized area toward the base of the heart and reentered on the other side while simultaneously spreading into the depth of the wall. Thus a scroll wave with a ribbon-shaped filament was formed during external shock-induced arrhythmia. Fluorescent imaging and passive bidomain simulations demonstrated that virtual electrode polarization-induced scroll waves underlie mechanisms of shock-induced vulnerability and failure of external defibrillation.     

Linear algebraic transformations of the bidomain equations: Implications for numerical methods

A mathematical framework is presented for the treatment of the bidomain equations used to model propagation in cardiac tissue. This framework is independent of the model used to represent membrane ionic currents and incorporates boundary conditions and other constraints. By representing the bidomain equations in the operator notation , various algebraic transformations can be expressed as , where P and Q are linear operators. The authors show how previous work fits into this framework and discuss the implications of various transformation for numerical methods of solution. Although such transformations allow many choices of independent variable, these results emphasize the fundamental importance of the transmembrane potential.     

Current injection into a two-dimensional anisotropic bidomain.

A two-dimensional sheet of anisotropic cardiac tissue is represented with the bidomain model, and the finite element method is used to solve the bidomain equations. When the anisotropy ratios of the intracellular and extracellular spaces are not equal, the injection of current into the tissue induces a transmembrane potential that has a complicated spatial dependence, including adjacent regions of depolarized and hyperpolarized tissue. This behavior may have important implications for the electrical stimulation of cardiac tissue and for defibrillation.     

Virtual electrodes in cardiac tissue: a common mechanism for anodal and cathodal stimulation.

Traditional cable analyses cannot explain complex patterns of excitation in cardiac tissue with unipolar, extracellular anodal, or cathodal stimuli. Epifluorescence imaging of the transmembrane potential during and after stimulation of both refractory and excitable tissue shows distinctive regions of simultaneous depolarization and hyperpolarization during stimulation that act as virtual cathodes and anodes. The results confirm bidomain model predictions that the onset (make) of a stimulus induces propagation from the virtual cathode, whereas stimulus termination (break) induces it from the virtual anode. In make stimulation, the virtual anode can delay activation of the underlying tissue, whereas in break stimulation this occurs under the virtual cathode. Thus make and break stimulations in cardiac tissue have a common mechanism that is the result of differences in the electrical anisotropy of the intracellular and extracellular spaces and provides clear proof of the validity of the bidomain model.