Anatomically Detailed Patient-specific Closed-loop Modeling of Heart-pacemaker Interaction

We present an anatomically detailed computational closed-loop model of whole-heart-pacemaker interaction based on patient-specific geometry.The whole-heart model includes tissue anisotropy and a fast conduction system simulating action potential propagation along the atrioventricular node and the His-Purkinje conduction system.We coupled the whole-heart model with a dual-chamber pacemaker model that processes the atrial and ventricular electrograms simulated by the heart model and coherently produces pacing stimuli.Depolarization and repolarization sequences in our whole-heart model are coherent with clinical data in healthy and pathological scenarios.Moreover, our results showed that the closed-loop model can emulate the heartpacemaker interaction in clinically relevant scenarios such as the insurgence of endless loop tachycardia.Thus, our closed-loop system provides a promising patient-specific environment for studying the interaction between the heart tissue and the stimulation device.