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research article

Defining myocardial fiber bundle architecture in atrial digital twins

Piersanti, Roberto
•
Bradley, Ryan
•
Ali, Syed Yusuf
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April 1, 2025
Computers in Biology and Medicine

A key component in developing atrial digital twins (ADT) - virtual representations of patients’ atria — is the accurate prescription of myocardial fibers which are essential for the tissue characterization. Due to the difficulty of reconstructing atrial fibers from medical imaging, a widely used strategy for fiber generation in ADT relies on mathematical models. Existing methodologies utilize semi-automatic approaches, are tailored to specific morphologies, and lack rigorous validation against imaging fiber data. In this study, we introduce a novel atrial Laplace–Dirichlet-Rule-Based Method (LDRBM) for prescribing highly detailed myofiber orientations and providing robust regional annotation in bi-atrial morphologies of any complexity. The robustness of our approach is verified in eight extremely detailed bi-atrial geometries, derived from a sub-millimeter Diffusion-Tensor-Magnetic-Resonance Imaging (DTMRI) human atrial fiber dataset. We validate the LDRBM by quantitatively recreating each of the DTMRI fiber architectures: a comprehensive comparison with DTMRI ground truth data is conducted, investigating differences between electrophysiology (EP) simulations provided by either LDRBM and DTMRI fibers. Finally, we demonstrate that the novel LDRBM outperforms current state-of-the-art (LDRBMs and Universal Atrial Coordinates) fiber models, confirming the exceptional accuracy of our methodology and the critical importance of incorporating detailed fiber orientations in EP simulations. Ultimately, this work represents a fundamental step towards the development of physics-based digital twins of the human atria, establishing a new standard for prescribing fibers in ADT.

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Type
research article
DOI
10.1016/j.compbiomed.2025.109774
Scopus ID

2-s2.0-85217276842

PubMed ID

39946790

Author(s)
Piersanti, Roberto

Politecnico di Milano

Bradley, Ryan

Alliance for Cardiovascular Diagnostic and Treatment Innovation

Ali, Syed Yusuf

Johns Hopkins Department of Biomedical Engineering

Quarteroni, Alfio  

École Polytechnique Fédérale de Lausanne

Dede’, Luca

Politecnico di Milano

Trayanova, Natalia A.

Alliance for Cardiovascular Diagnostic and Treatment Innovation

Date Issued

2025-04-01

Published in
Computers in Biology and Medicine
Volume

188

Article Number

109774

Start page

109774

Subjects

Cardiac digital twin

•

Cardiac fiber architecture

•

Computational modeling

•

Numerical simulations

•

Precision medicine

Editorial or Peer reviewed

REVIEWED

Written at

EPFL

EPFL units
PH-SB  
FunderFunding(s)Grant NumberGrant URL

Leducq Foundation

Dipartimento di Matematica

Politecnico di Milano

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Available on Infoscience
May 26, 2025
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/250536
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