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N. Biasi, and A. Tognetti. "Modelling whole heart electrical activity for ischemia and cardiac pacing simulation." Health and Technology 10.4 (2020): 837-850.

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We developed a finite element model of the electrical activity of the whole heart embedded in the torso that is proposed as an useful tool to simulate myocardial ischemia and cardiac pacing. The electrical activity of the cardiac tissue is reproduced with a bidomain model incorporated with the FitzHugh-Nagumo equations. The finite element model is developed in Comsol Multiphysics, both in two and in three dimensions. Myocardial ischemia and bradycardia can be easily simulated by simple changes to the parameters of the model. We simulated apical, anterior and posterior ischemias and the relative electrocardiographic signals. The model was exported in Simulink environment to develop a closed-loop model of cardiac pacing. We chose a demand inhibited pacemaker, which stimulates the myocardium only if the intrinsic activity of the heart is not revealed, but every type of pacemaker can be simulated. The model generates a controlled spontaneous activation in the sinoatrial node and it is also able to reproduce realistic electrocardiographic signals and the effects that the stimulation and the pathological conditions has on them.

Keywords: Cardiac bidomainClosed loop pacemaker simulationHeart modellingMyocardial ischemia simulation