Sustained reentry in a 3d regionally ischemic human heart. A simulation study

In this work, we have studied the vulnerable window and propagation patterns in a human heart during acute ischemia. A 3-D biventricular model of a human heart with realistic heterogeneity and fiber orientations has been considered. The ischemic region was located in the anterior left ventricular wall mimicking the occlusion of the circumflex artery. The electrical activity of the tissue was modeled with the monodomain model along with a modified version of the ten Tusscher 2006 ionic model. The model predicts the generation of sustained re-entrant activity in the form of a rotor around the ischemic zone. Patterns in the form of figure-of-eight were also observed within the vulnerable window. The re-entrant activity originates in the endocardial surface and propagates transmurally towards the epicardium.