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Title: Computational methods for the estimation of cardiac electrophysiological conduction parameters in a patient specific setting
Author: Wallman, Kaj Mikael Joakim
Awarding Body: University of Oxford
Current Institution: University of Oxford
Date of Award: 2013
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Cardiovascular disease is the primary cause of death globally. Although this group encompasses a heterogeneous range of conditions, many of these diseases are associated with abnormalities in the cardiac electrical propagation. In these conditions, structural abnormalities in the form of scars and fibrotic tissue are known to play an important role, leading to a high individual variability in the exact disease mechanisms. Because of this, clinical interventions such as ablation therapy and CRT that work by modifying the electrical propagation should ideally be optimized on a patient specific basis. As a tool for optimizing these interventions, computational modelling and simulation of the heart have become increasingly important. However, in order to construct these models, a crucial step is the estimation of tissue conduction properties, which have a profound impact on the cardiac activation sequence predicted by simulations. Information about the conduction properties of the cardiac tissue can be gained from electrophysiological data, obtained using electroanatomical mapping systems. However, as in other clinical modalities, electrophysiological data are often sparse and noisy, and this results in high levels of uncertainty in the estimated quantities. In this dissertation, we develop a methodology based on Bayesian inference, together with a computationally efficient model of electrical propagation to achieve two main aims: 1) to quantify values and associated uncertainty for different tissue conduction properties inferred from electroanatomical data, and 2) to design strategies to optimise the location and number of measurements required to maximise information and reduce uncertainty. The methodology is validated in several studies performed using simulated data obtained from image-based ventricular models, including realistic fibre orientation and conduction heterogeneities. Subsequently, by using the developed methodology to investigate how the uncertainty decreases in response to added measurements, we derive an a priori index for placing electrophysiological measurements in order to optimise the information content of the collected data. Results show that the derived index has a clear benefit in minimising the uncertainty of inferred conduction properties compared to a random distribution of measurements, suggesting that the methodology presented in this dissertation provides an important step towards improving the quality of the spatiotemporal information obtained using electroanatomical mapping.
Supervisor: Rodríguez, Blanca; Smith, Nicholas Sponsor: European Commission ; Medical Research Council
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: Biology and other natural sciences (mathematics) ; Mathematical biology ; Partial differential equations ; Probability theory and stochastic processes ; Cardiovascular disease ; Probability ; cardiac simulations ; Bayesian inference ; parameter estimation ; cardiac electrophysiology