Atrial Models with Personalized Effective Refractory Period
Creators
Description
Impact of Effective Refractory Period Personalization on Prediction of Atrial Fibrillation Vulnerability
Folder structure
- `src`: contains the source files needed to run PEERP protocol
- `run.py` This is the main function to run the pacing protocol (not needed to run if reentries are only reproduced, check reproduceReentry.py)
- `induceReentry.py` Contains a list of pacing protocols. The PEERP protocol is included here
- `getStimPoints.py` Extract the stimulation points
- `element_tag.csv` Region tag numbering
- `al_mk_H.par` Par file with ionic scaling factors for three states; H:Healthy, M:Mild, S:Severe
- `requirements.txt` Packages to create the virtual enviroment. (This was my output of ```pip3 list> requirements.txt```)
- `reproduceReentry.py` Reentries can be reproduced given a selected folder where the .par and .roe files are stored.
- `data`: contains the `meshes` folder with the bilayer meshes in openCARP (.elem, .lon and .pts) and .vtk format. Synthetic fibrotic distributions are included in the the .regele files.
- `meshes/P1/P1_with_erp_lat_bi.vtk` Mesh with ERP, LAT and bipolar voltage data
- `meshes/P1/ERP_values.txt/` measured ERP data
- `meshes/P1/ERP.pts/` electrode coordinates where ERP data was measured
- `meshes/P1/ablation.pts/` electrode coordinates where tissue was ablated
- `meshes/P1/LA_stim_points_2cm.pts` Stimulation points for the PEERP protocol
- `meshes/P1/bilayer/LA_bilayer_with_fiber_slow_conductive.regele` Element ids corresponding to regions of low voltage (< 0.5mV)
- `meshes/P1/bilayer/LA_bilayer_with_fiber_scar.regele` Element ids corresponding to regions of low voltage (< 0.1mV)
- `meshes/P1/bilayer/LA_bilayer_with_erp_regions_um.vtk` Bilayer mesh with a discrete split where each region has a single ERP value
- `meshes/P1/bilayer/LA_bilayer_with_fiber_with_fibrosis.vtk` Bilayer mesh with fibrosis informed by low voltage areas
- `meshes/P1/bilayer/LA_bilayer_with_erp_continuous_um.vtk` Bilayer mesh with a continuous ERP distribution by interpolation of measured ERP data
- `meshes/P1/bilayer/LA_bilayer_with_erp_continuous_2ms_um.vtk` Bilayer mesh with a continuous ERP distribution by interpolation of measured ERP data with +- 2ms perturbation
We studied 7 different scenarios:
- Monoregion scenario with no ERP personalization, where all nodes had the same ERP
- Control scenario with no ERP personalization, where ERP nodes of certain defined anatomical regions where modified as reported in Loewe et al. 2015
- Regional scenario with ERP personalization, where each region had a single ERP value derived from clinical measurement
- Continuous scenario with ERP personalization, where the ERP distribution was generated by interpolation of measured ERP data
- Control scenario with fibrosis, where elements corresponding to regions of low voltage (bi<0.5 mV) where set as slow or non conducing elements
- Continuous scenario with fibrosis, where elements corresponding to regions of low voltage (bi<0.5 mV) where set as slow or non conducing elements
- Continuous scenario where ERP measurements with additional perturbation draw from a uniform distribution. The perturbations were 2,5,10 and 20 ms, and we repeated this set 5 times for P6
In summary, we provide the following data:
- 7 meshes for openCARP simulations
- 7 meshes in vtk format with continuous ERP distribution
- 27 meshes in vtk format with continuous ERP distribution with perturbed ERP with 2,5,10 and 20ms from a random uniform distribution
- 7 meshes in vtk format with regional ERP
- 7 meshes in vtk format with ERP, LAT and bipolar voltage
- 7 ablation set points
- 7 ERP set points with their corresponding values
- 209 reentries generated under 4 ERP scenarios (monoregion, control,regional,continuous) run with a conduction velocity of 0.7 0.5 and 0.3 m/s
- 26 reentries generated under 2 scenarios ERP+Fibrosis (control + continuous) run with a conduction velocity 0.3 m/s
- 37 reentries induced with continuous ERP for patient P3 @CV 0.3 for the sensitivity analysis
Create a dynamic Courtemanche model
As we will modify the ionic parameters on a nodel basis you will need to create a dynamic Courtemanche model and then declare the variables (ionic conductances) you need to modify. In your openCARP installation folder, go to the `limpet` copy the Courtemanche.model file
```
cd openCARP/physics/model/limpet
cp Courtemanche.model Courtemanche_nodal.model
vim Courtemanche_nodal.model
```
Then add on top the parameters that need to be modified on a nodal-basis:
```
group {
GK1 ;
Gto ;
GKr ;
GKs ;
GCaL ;
factorGKur ;
maxINaCa ;
maxIpCa ;
} .nodal();
```
Then you would need to recompile openCARP. In the terminal, go to your openCARP's top level folder:
```
cd openCARP/
```
Configure CMake with updated imp_list.txt via:
```
cmake -S. -B_build -DUPDATE_IMPLIST=ON
```
Run the CMake building process:
```
cmake --build _build
```
This will generate the `.h` and `.cc` files for your dynamic model inside `physics/limpet/src/imps_src`
**Note:** If you want to add or modify a model file after openCARP was compiled, it is possible to first clean the previous generated files during compilation by running `make clean` before recompiling openCARP.
If you compile your own version of openCARP, then you can modify the settings.yaml file, to point to your openCARP version with the dynamic model.
```
cd .config/carputils
subl settings.yaml
```
Add the build name:
```
CARP_EXE_DIR:
CPU: /Users/lm104/Documents/OpenCARP/opencarp/_build/bin
NODAL: /Users/lm104/Documents/OpenCARP/openCARP_nodal_adj/_build/bin
```
You can check that the new dynamic model is there by calling bench
```
bench -—list-imps
bench —-imp Courtemanche_nodal --imp-info
```
You can find additional information about dynamic models here.
Reproduce the reentries
Preparation before running the PEERP pacing protocol
Run the PEERP protocol
Running your own experiment and making your own changes
Files
data.zip
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Additional details
Related works
- Is described by
- Conference proceeding: 10.1093/europace/euad122.542 (DOI)
Funding
Dates
- Available
-
2024-02-29