Monday, 18 November 2019, 10 a.m. (sharp),

prof. Julius Guccione, University of California, San Francisco, USA,

at the conference room of IMATI CNR in Pavia, will give a lecture titled:

In-silico study of the cardiac arrhythmogenic potential of biomaterial injection therapy




In-silico study of the cardiac arrhythmogenic potential of

biomaterial injection therapy

William A. Ramı́rez 1, Alessio Gizzi 2, Kevin L. Sack 3 4, Julius M. Guccione 3, and Danie E. Hurtado 1 5 6,

1. Department of Structural and Geotechnical Engineering, School of Engineering, Pontificia
Universidad Católica de Chile, Santiago, Chile.

2. Nonlinear Physics and Mathematical Modeling Lab, Department of Engineering, Campus Bio-
Medico University of Rome, Rome, Italy.

3. Department of Surgery, University of California at San Francisco, San Francisco, CA, United States.
4. Division of Biomedical Engineering, Department of Human Biology, University of Cape Town,
Cape Town, South Africa.
5. Institute for Biological and Medical Engineering, Schools of Engineering, Medicine and Biological
Sciences, Pontificia Universidad Católica de Chile, Santiago, Chile.
6. Millennium Nucleus for Cardiovascular Magnetic Resonance.


Biomaterial injection treatment to improve the cardiac function of hearts with ischemic heart
failure (HF) has shown many positive outcomes in preclinical applications. However, the
influence of this therapy on the behavior of action potential propagation has not been clearly
elucidated. In this work, we developed computational models of swine hearts to study the
electrophysiological vulnerability associated with biomaterial injection therapy. Action potential

propagation was simulated using a monodomain approach and geometrical models of high-
resolution MRI and diffusion tensor-MRI data from normal, untreated, and treated hearts. The

regional restitution properties of each heart were evaluated by constructing a density function
distribution of the action potential duration (APD) restitution curve while account for the
arrangement of biomaterial injections, infarcted zones (IZ) and gray zones (GZ) within the
myocardium. In addition, a comparative analysis of the ventricular fibrillation (VF) dynamics for
every heart was done by measuring the number of filaments formed after wave brake. Finally, a
preliminary sensitivity analysis to measure the influence of biomaterial conductivity was made in
a VF scenario. Our results show that injection of biomaterials does not alter the regional
distribution of the APD restitution curve. Further, biomaterial injections do not seem to affect the
VF dynamics arising in hearts with ischemic HF. The sensitivity analysis of the biomaterial
conductivity shows that biomaterial injection seems not to change VF dynamics substantially in
treated hearts, compared with untreated hearts. This work represents a proof-of-concept that
high-performance computer simulations of the heart can be used to gain insights, in silico, of
biomaterial injection treatments and their arrhythmogenic potential.