In-silico Inducibility of Ventricular Tachycardia in Patient-Specific Post-Infarction Ventricular Models

Javier Villar Valero1, Juan Gomez2, David Soto-Iglesias3, Diego Penela3, Antonio Berruezo3, Beatriz Trenor1
1Universitat Politècnica de València, 2Valencian International University, 3Arrhythmia Department, Heart Institute, Teknon Medical Center


After myocardial infarction, the evolution of the cardiac scar and the remodeling of the border zone play a critical role in the generation of life-threatening ventricular tachycardias. Three-dimensional and anatomically realistic biventricular models can help understand the mechanisms underlying reentrant arrhythmias in such circumstances. In the present work, personalized models of infarcted hearts are built from late gadolinium enhancement cardiac magnetic resonance images. The electrical activity of these hearts is simulated under different remodeling scenarios of the scar border zone. After applying the same stimulation protocol applied by clinicians to the virtual heart of a patient presenting ventricular tachycardia (VT) and to a patient presenting no tachycardia, we could replicate the arrhythmogenic behavior of these hearts for specific conditions of structural remodeling of the border zone. Our simulations reproduced realistic patterns of reentry consistent with those obtained in the clinic, providing a better understanding of the mechanisms underlying VT.