Rapid progress in virtual heart modeling shows great promise for improved outcomes
Natalia A. Trayanova, Johns Hopkins Department of Biomedical Engineering Murray B. Sachs Professor and faculty in the Institute for Computational Medicine, created computer models of the human heart for basic scientific research. Now she’s creating customized virtual heart models for individual cardiac patients.
In her Computational Cardiology Laboratory at Johns Hopkins University, Trayanova’s team creates computer models to simulate individual patients’ hearts in order to help cardiologists carry out life-saving treatments.
Biomedical engineers have learned how to use numerical models to generate increasingly sophisticated “virtual organs” over the past decade. But rapid developments in cardiac simulation have made the virtual heart the most complete model of all. Such models may soon transform medicine, ushering in a new kind of personalized health care with radically improved outcomes.
The virtual heart model is complex replica, as it must mimic the heart’s workings at the molecular scale, through the cellular scale, and up to the level of the whole organ, where muscle tissue expands and contracts with every heartbeat. Heart modeling at these different scales must be tightly integrated to accurately render the constant feedback interactions that govern the functions of the heart.
Dr. Trayanova and her colleagues are now testing whether patient-specific heart models can be used to make better predictions of a person’s risk of developing a life- threatening arrhythmia, and hence his or her need for an implanted defibrillator. By stressing the virtual heart with electrical signals, the risk can be weighed based on exactly how prone that patient is to repeated arrhythmia. The team is working toward a day when cardiologists routinely order these virtual tests as a noninvasive way of screening their patients and gauging their risk of sudden cardiac death.
It is also expected that the virtual heart model may be improve treatment of life-threatening ventricular tachycardia — where traditional ablation stopped only in 54 percent of patients and 8 percent of those patients experienced complications. Using the virtual heart model, doctors could locate the tissue responsible for the faulty electric pulses and then target it for ablation. The cardiologist would navigate the ablation tool to those precise locations and destroy the minimum amount of tissue needed to do the job. It is expected that this approach will significantly shorten the ablation procedure, decrease complications, and increase the rate of success.
Dr. Trayanova and her team of researchers expect that this new kind of personalized health care using computer-simulated heart models will “change the paradigm” of cardiac treatment and outcomes.