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This book targets three fields of computational multi-scale cardiac modeling. First, advanced models of the cellular atrial electrophysiology and fiber orientation are introduced. Second, novel methods to create patient-specific models of the atria are described. Third, applications of personalized models in basic research and clinical practice are presented. The results mark an important step towards the patient-specific model-based atrial fibrillation diagnosis, understanding and treatment.
Catheter ablation is a major treatment for atrial tachycardias. Hereby, the precise monitoring of the lesion formation is an important success factor. This book presents computational, wet-lab, and clinical studies with the aim of evaluating the signal characteristics of the intracardiac electrograms (IEGMs) recorded around ablation lesions from different perspectives. The detailed analysis of the IEGMs can optimize the description of durable and complex lesions during the ablation procedure.
An early detection and diagnosis of atrial fibrillation sets the course for timely intervention to prevent potentially occurring comorbidities. Electrocardiogram data resulting from electrophysiological cohort modeling and simulation can be a valuable data resource for improving automated atrial fibrillation risk stratification with machine learning techniques and thus, reduces the risk of stroke in affected patients.
The atrial substrate undergoes electrical and structural remodeling during atrial fibrillation. Detailed multiscale models were used to study the effect of structural remodeling induced at the cellular and tissue levels. Simulated electrograms were used to train a machine-learning algorithm to characterize the substrate. Also, wave propagation direction was tracked from unannotated electrograms. In conclusion, in silico experiments provide insight into electrograms' information of the substrate.
Multiscale modeling of cardiac electrophysiology helps to better understand the underlying mechanisms of atrial fibrillation, acute cardiac ischemia and pharmacological treatment. For this purpose, measurement data reflecting these conditions have to be integrated into models of cardiac electrophysiology. Several methods for this model adaptation are introduced in this thesis. The resulting effects are investigated in multiscale simulations ranging from the ion channel up to the body surface.AbstractEnglisch = Multiscale modeling of cardiac electrophysiology helps to better understand the underlying mechanisms of atrial fibrillation, acute cardiac ischemia and pharmacological treatment. For this purpose, measurement data reflecting these conditions have to be integrated into models of cardiac electrophysiology. Several methods for this model adaptation are introduced in this thesis. The resulting effects are investigated in multiscale simulations ranging from the ion channel up to the body surface.
Half of the patients suffering from atrial fibrillation (AF) cannot be treated adequately, today. This book presents multi-scale computational methods to advance our understanding of patho-mechanisms, to improve the diagnosis of patients harboring an arrhythmogenic substrate, and to tailor therapy. The modeling pipeline ranges from ion channels on the subcellular level up to the ECG on the body surface. The tailored therapeutic approaches carry the potential to reduce the burden of AF.
ECG imaging was performed in humans to reconstruct ventricular activation patterns and localize their excitation origins. The precision of the non-invasive reconstructions was evaluated against invasive measurements and found to be in line with the state-of-the-art literature. Statistics were produced for various excitation origins and reveal the beat-to-beat robustness of the imaging method.
Presenting a systematic article-by-article commentary on the European Service Regulation (recast), and written by renowned experts from several EU Member States, this book gives guidance for the proper understanding and practical operation of cross-border judicial cooperation in civil and commercial matters within the EU.
The settling of disputes in international trade and in large and technically complex construction projects can hardly be imagined without the institution that is arbitration. Another thing we can be sure about is that insolvency will also remain a part of the lifecycle of business entities within the currently existing economic system. Whereas insolvency proceedings are heavily regulated with little leeway for the parties, the central tenet of arbitration is the autonomy of the parties. Hence this book aims to thoroughly investigate the many legal issues arising in arbitral proceedings when insolvency and arbitration clash. This interaction is increasingly frequent today. Providing much-need...
This work presents methods to advance electrophysiological simulations of intracardiac electrograms (IEGM). An experimental setup is introduced, which combines electrical measurements of extracellular potentials with a method for optical acquisition of the transmembrane voltage in-vitro. Thereby, intracardiac electrograms can be recorded under defined conditions. Using experimental and clinical signals, detailed simulations of IEGMs are parametrized, which can support clinical diagnosis.