Electrical propagation patterns in a 3D regionally ischemic human heart: A simulation study

In this work, we have studied the different propagation patterns displayed in a human heart during acute ischemia. A 3-D geometrically and anatomically accurate regionally ischemic human heart was simulated. The ischemic region was located in the anterior side of the left ventricle mimicking the occlusion of the circumflex artery. Realistic heterogeneity and fiber anisotropy has been considered in the model. The electrical activity of each cell was reproduced using a modified version of the ten Tusscher 2006 action potential model. The model predicts the generation of figure-of-eight re-entries which cross the central ischemic zone formed in the epicardial surface due to the longer refractory period of the midmyocardial layers. Also, focal activity experimentally observed in the epicardium could be caused by re-entrant wavefronts propagating in the mid-myocardium that reemerge in the heart surface.