Computing and visualizing electric potentials and current pathways in the thorax

Tipping the scales of understanding: An engineering approach to design and implement whole-body cardiac electrophysiology experimental models

The study of cardiac electrophysiology is built on experimental models that span all scales, from ion channels to whole-body preparations. Novel discoveries made at each scale have contributed to our fundamental understanding of human cardiac electrophysiology, which informs clinicians as they detect, diagnose, and treat complex cardiac pathologies. This expert review describes an engineering approach to developing experimental models that is applicable across scales. The review also outlines how we applied the approach to create a set of multiscale whole-body experimental models of cardiac electrophysiology, models that are driving new insights into the response of the myocardium to acute ischemia. Specifically, we propose that researchers must address three critical requirements to develop an effective experimental model: 1) how the experimental model replicates and maintains human physiological conditions, 2) how the interventions possible with the experimental model capture human pathophysiology, and 3) what signals need to be measured, at which levels of resolution and fidelity, and what are the resulting requirements of the measurement system and the access to the organs of interest. We will discuss these requirements in the context of two examples of whole-body experimental models, a closed chest in situ model of cardiac ischemia and an isolated-heart, torso-tank preparation, both of which we have developed over decades and used to gather valuable insights from hundreds of experiments.

Challenges facing validation of noninvasive electrical imaging of the heart

Noninvasive imaging of regional cardiac electrophysiology remains an elusive target. Such imaging is still in its infancy, particularly in comparison to structural imaging modalities such as magnetic resonance imaging (MRI), x-ray computed tomography (CT), and ultrasound. We present an overview of noninvasive ECG imaging, and the challenges and successes of the various techniques across a range of applications. Unlike MRI and CT, reconstructing cardiac electrophysiology from remote body surface measurements is a highly ill-posed problem. We therefore first review the theoretical considerations and associated algorithms that are used to address this issue. We then focus on the important issue of validation, and review and contrast recent advances in this area. Efforts to validate ECG inverse procedures using a modeling-based approach are addressed first. We then discuss various experimental studies that have been conducted to provide appropriate data for robust validations. We present new data that are simultaneously recorded from dense arrays of electrodes on the epicardium and body surface of anesthetized pigs during sinus rhythm, ventricular pacing, and regional ischemia. These data have been obtained specifically to help validate inverse ECG procedures, and form a useful supplement to recent clinical validation studies. Finally, clinical applications and outstanding issues regarding noninvasive imaging of regional cardiac electrophysiology are addressed.