Virtual heart provides insight into atrial fibrillation

A virtual heart developed at Manchester University is claimed to be revealing new information about a common heart condition.

Researchers at the School of Physics and Astronomy built an advanced computational model of an anatomically correct sheep’s heart. It was made by taking a series of very thin slices of the heart, imaging them in 2D and then using a computer program to render them into a 3D model.

The reconstruction is said to include details of the complex fibre structure of the tissue, and the segmentation of the upper chambers of the heart into known distinctive atrial regions.

Single-cell models that take into account information about the electrical activity in different atrial parts of the heart were then incorporated into the model. The virtual heart was then used to investigate the condition atrial fibrillation (AF).

Research leader Prof Henggui Zhang said: ‘AF affects approximately 1.5 per cent of the world’s population. In the UK more than 500,000 patients have been diagnosed with the condition, which causes an irregular heart rate. It is also known to increase the risk and severity of stroke. Despite its prevalence very little is known about what causes AF.’

AF occurs when abnormal electrical impulses suddenly start firing in the upper chambers of the heart. These impulses are said to override the heart’s natural pacemaker, which can no longer control the rhythm of the heart. This desynchronises the heart muscle contraction and reduces the heart’s efficiency and performance.

Zhang and his team reportedly focused on the pulmonary vein, which is a common area that initially triggers AF. They simulated erratic electrical waves passing through the vein and the surrounding atrial tissue, and then studied the impact this had on the rest of the heart.

They found that regional differences in the electrical activity across the tissue of the heart — electrical heterogeneity — is key to the initiation of AF.

According to the university, the largest electrical difference was between the pulmonary vein and the left atrium, which may help explain why the pulmonary vein region is a common source of irregular heartbeats.

The scientists also identified that the fibre structure of the heart plays an important role in the development of AF as there were directional variations in the conduction of electrical waves along and across the fibres — a phenomenon called anisotropy.

In a statement, Zhang said: ‘This study has for the first time identified the individual role of electrical heterogeneity and fibre structure in the initiation and development of AF. It has not previously been possible to study the contribution of the two separately but using our computational model we’ve been able to clearly see that both electrical heterogeneity and fibre structure need to be taken into consideration when treatment strategies for AF are being devised.’

The next step for Zhang and his team will be to find a way to target the electrical conduction in specific regions of the heart to better protect against AF. They also want to use their virtual heart to gain a deeper understanding of AF and to apply their findings to the development of more effective treatments.