A Full Physics Real-Time Solver for Simulating Arrhythmias in the Human Heart

For simulating human cardiac electrophysiology (CEP), the bidomain model is considered the gold standard owing to its ability to replicate experimental observations with high fidelity.However, its reaction-diffusion (RD) nature and associated constraints on spatiotemporal discretization result in significant computational costs, limiting its adoptions in industrial and clinical applications.Eikonalbased models are computationally more efficient but lack the capability to accurately simulate cardiac arrhythmias.We present a real-time capable reentrant eikonal model (REK) that combines an eikonal solver with a finite state machine (FSM) to track action potential phases and incorporates physiological restitution, curvature and diffusion effects, as measured in a high fidelity reference RD model.Local activation times (LATs), conduction velocities (CVs) and local repolarization times (LRTs) measured in infarct simulations were compared against baseline RD monodomain solutions, where low root mean square errors (RMSEs) of 2.4 ms, 1.6 mm/s and 6.8 ms were reported, respectively.Reconstructed transmembrane voltages and electro-cardiograms (ECGs) qualitatively agree closely with the baseline solution, while offering a speedup of 420.Our results demonstrate that the REK model is capable of simulating cardiac arrhythmias in real-time, matching monodomain solutions with minor deviations.