Study On The Impact Of Simulation Time On Reentry Morphology In Heart Simulation

Ventricular tachycardia(VT),referred to as ventricular tachycardia,is the most common cause of sudden cardiac death.Ventricular tachycardia often occurs in patients with myocardial infarction.It is very important to establish a virtual heart model based on the patient's personalization to simulate the occurrence of ventricular tachycardia.In view of the fact that the guidance of clinical ventricular tachycardia based on the patient's personalized cardiac modeling simulation requires very high time nodes(generally only 1-2 days from the patient's magnetic resonance scan to the patient's surgery),and the simulation is very resource-intensive(one simulation requires a CPU with more than 1000 cores runs continuously for about 24hours),so most international teams choose 3-5 seconds for the simulation time after successful reentry induction when using cardiac modeling simulation to guide clinical ventricular ablation.Recent studies have found that some reentrants fail to reach a stable state at the end of the 3-5second simulation,so the position of the reentrant cannot be determined in the simulation,so it is impossible to locate the accurate lesion and ablation target in the simulation.To solve the problem of the lack of optimal simulation time in the process of clinical ventricular tachycardia guided by cardiac modeling and simulation,this paper first established and simulated 4 patients' personalized cardiac models.A total of 4 patients with ventricular tachycardia caused by coronary heart disease were collected.For the acquired Late gadoliniumenhanced magnetic resonance imaging(LGE-MRI)data,this article innovatively uses the Gaussian mixture model(GMM)classification method and the automatic extraction algorithm of infarct area to classify the patient's heart tissue into 3 different areas: non-infarct area and semi-infarct area and complete infarct area.Compared with traditional clinical segmentation methods,this algorithm has the advantages of higher accuracy,full automaticity,and high repeatability.Based on our lab's previous simulation platform,a clinically similar induction method was used to induce VT.After the VT was successfully induced,we performed a 10-second simulation,and then analyzed the shortest simulation time for each turnback to reach stability,and established the best simulation time and its setting method to achieve the optimal use of computer resources,and meet the time node requirements for clinical surgery on patients.The statistical analysis of the 4 patient models showed that the volume of the non-infarct area was 167.27±48.65 cm3,the volume of the semi-infarct area was 7.23±3.87 cm3,and the volume of the complete infarction area was 5.83±4.38 cm3.Ventricular tachycardia was induced in the 4 patient models,which was completely consistent with the clinical results.In the model,27 stimulation sites induced persistent reentry,including anatomical and functional reentry,accounting for 44.5% and 55.5%,respectively.Through the analysis of different simulation durations,it is found that the anatomical reentry can reach stability within 1-3seconds,while the simulation time of the functional reentry is not fixed.The stable time range of different reentry in the model varies from 2 seconds to 8 seconds.Based on the research of this paper,not only the simulation accuracy can be improved,but also the unnecessary simulation time can be reduced to achieve the optimal use of computer resources,thereby improving the simulation efficiency and shortening the simulation time to meet the time node requirements of clinical surgery on patients.