A Numerical Study of the Electrophysiological Substrate Triggering Ventricular Tachycardia

Stefano Pagani1, Antonio Frontera2, Luca Dede'1, Andrea Manzoni1, Luca Limite2, Paolo Della Bella2, Alfio Quarteroni1
1Politecnico di Milano, 2IRCCS San Raffaele Hospital


We present a new personalized computational model to numerical simulate arrhythmias obtained by integrating activation time and voltage data collected with high-density mapping during sinus rhythm (SR) in post-myocardial infarction patients. The mathematical model consists of a coupled system of partial and ordinary differential equations (PDE-ODEs), formed by the modomain model for the description of the electrical potential and the ten Tusscher-Panfilov model for the characterization of ionic species dynamic. The resulting PDE-ODEs system is discretized using the Finite Element Method in space and Backward Euler scheme in time and then solved numerically. We investigate ventricular tachycardia (VT) induction and sustainment on varying the pacing interval and location. We verify the ability of the model in reproducing patients’ re-entrant circuits by comparing the numerical results with the full activation maps of the VT circuits.

We also present an analysis of the conduction velocities computed from activation time data, aimed at better understanding the substrate characteristics responsible for VT. We show the presence of multiple slow conduction areas along the entire reentry circuit (isthmus and outerloop), together with dynamic properties of the electrical propagation assessed by comparing conduction velocities in SR and VT.

This project has received funding from the European Research Council under the European Unions Horizon 2020 research and innovation programme (grant n. 740132).