Abstract
A computer simulation model of cardiac rhythm disturbances and of the heart/pacemaker interaction has been created and implemented on a NORD-100 minicomputer. The model incorporates important properties including cycle length dependence of the refractory periods of different parts of the heart and of the atrioventricular nodal conduction speed. Computational experiments produce an explicit timetable of polarisation changes, a simulated one-channel electrocardiographic record and a pacemaker marker channel. The simulation program is written infortran and uses discrete event simulation techniques. The heart is modelled using instances of nine simulation process prototypes. The paper presents and discusses several examples in the form of simulated electrocardiographic records and the results show that the model is clinically relevant. Included in the examples are the modelling of rhythm disturbances, pacemaker actions, pacing for tachycardia prophylaxis and atrioventricular nodal conduction disorders.
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Ahnve, S. andVallin, H. (1982) Influence of heart rate and inhibition of autonomic tone on the QT interval.Circ.,65, 435–439.
Conover, M. H. andZallis, E. G. (1976)Understanding electrocardiography: physiological and interpretive concepts. C.V. Mosby Co., St. Louis, Chap. 12, 118–126.
Coumel, P. (1970) Management of paroxysmal tachycardia. InSymposium on cardiac arrhythmias.Sandoe, E., Flensted-Jensen, E. andOlesen, K. H. (Eds.), Ab Astra, Sweden, 783.
Cuffin, B. N. andGeselowitz, D. B. (1977) Studies on the electrocardiogram using realistic cardiac and torso models.IEEE Trans.,BME 24, 242–252.
Dassen, W., Brugada, P., den Dulk, K., Gorgels, A. andWellens, H. (1983) A mathematical model to study pacemaker related tachyarrhythmias, In:Computers in Cardiology,Ripley,K. L. (Ed.), IEEE Computer Society, Silver Springs, pp. 407–410.
Dassen, W. R. M., van der Steld, A., van Braam, W., den Dulk, K., Gorgels, A. P. M., Brugada, P. andWellens, H. J. J. (1985) PACTOT: a reprogrammable software pacing system.Pacing Clin. Electrophys.,8, 574–578.
de Beer, E. L., Boom, H. B. K. andNaafs, B. (1977) The combined influence of the stimulus frequency on the vagal nerves and the atrial stimulus interval on the atrioventricular conduction time.Cardiovasc. Res.,11, 47–54.
Dorveaux, L., Heddle, W., Jones, M. andTonkin, A. (1985) Examination of an exponential model of conduction through the human atrioventricular node.Pacing Clin. Electrophys.,8, 646–655.
Drouhard, J. P. andRoberge, F. A. (1982a) The simulation of repolarization events of the cardiac Purkinje fiber action potential.IEEE Trans.,BME-29, 481–493.
Drouhard, J. P. andRoberge, F. A. (1982b) A simulation study of the ventricular myocardial action potential. ——Ibid.,BME-29, 494–502.
Franta, W. R. (1977)The process view of simulation. Elsevier, New York.
Furman, S. andFischer, J. D. (1982) Endless-loop tachycardia in an AV universal (DDD) pacemaker.Pacing Clin. Electrophys.,5, 486–489.
Gomes, J. A. C., Dhatt, M. S., Rubenson, D. S. andDamato, A. N. (1979) Electrophysiologic evidence for selective retrograde utilization of a specialized conducting system in atrioventricular nodal reentrant tachycardia.Am. J. Cardiol.,43, 687–698.
Gulrajani, R. M. andMailloux, G. E. (1983) A simulated study of the effects of torso inhomogeneities on electrocardiographic potentials, using realistic heart and torso models.Circ. Res.,52, 45–56.
Hagen, C. T., Dassen, W. R. M., Bump, T. E. andArzbaecher, R. C. (1983) Arrhythmia simulation by computer modelling of cardiac conduction. InComputers in cardiology,Ripley,K. L. (Ed.), IEEE Computer Society, Silver Springs 217–220.
Heethaar, R. M., van der Gon, D. J. J. andMeijler, F. L. (1973) Mathematical model of AV conduction in the rat heart.Cardiovasc. Res.,7, 105–114.
Holley, L. andUther, J. (1985) A computer model of ventricular electrical activity and its application to ventricular arrhythmias.Vectors,14, 14–18.
Kawataki, M., Kashima, T., Toda, H. andTanaka, H. (1984) Relation between QT interval and heart rate. Applications and limitations of Bazett's formula.J. Electrocardiol.,17, 371–376.
Malík, M., Cochrane, T. andCamm, A. J. (1983) Computer simulation of the cardiac conduction system.Comput. Biomed. Res.,16, 454–468.
Malík, M. andCochrane, T. (1985) Shell computer model of cardiac electropotential changes.J. Biomed. Eng.,7, 266–274.
Malík, M., Nathan, A. andCamm, A. J. (1985) Computer simulation of dual chamber pacemaker algorithms using a realistic heart model.Pacing Clin. Electrophys.,8, 579–588.
Malík, M. andCamm, A. J. (1986) Possible pathophysiology of torsade de pointes evaluated by a realistic heart computer model.Cardiovasc. Res.,20, 436–443.
Malík, M., Cochrane, T. andCamm, A. J. (1986a) Computer simulation of cardiac rhythm and artificial pacemakers using a ten element heart model.Comput. Biomed. Res.,19, 237–253.
Malík, M., Davies, D. W. andCamm, A. J. (1986b) Limiting factors in the use of DDD pacemakers to prevent junctional reentry: computer modeling experiments.Clin. Progr. Electrophys. Pac.,4, 137–146.
Miller, W. T. andGeselowitz, D. B. (1978) Simulation studies of the electrocardiogram.Circ. Res.,43, 301–323.
Nelson, C. V. andGeselowitz, D. B. (Eds.) (1976)The theoretical basis of electrocardiology. Oxford University Press, Oxford.
Olson, W. H., McConnell, M. V., Sah, R. L., Beck, R. C. andSutton, R. (1985) Pacemaker diagnostic diagrams.Pacing Clin. Electrophys.,8, 691–700.
Parsonnet, V., Furman, S. andSmyth, N. P. D. (1981) A revised code for pacemaker identification. ——Ibid.,4, 400–403.
Rickards, A. F. andNorman, J. (1981) Relation between AT interval and heart rate. New design of physiologically adaptive cardiac pacemaker.Br. Heart J.,45, 56–61.
Selvester, R. H., Solomon, J. andSapoznikov, D. (1979) Computer simulation of the electrocardiogram. InComputer techniques in cardiology.Cady, L. D. (Ed.), Marcel Dekker, New York/Basel, 417–454.
Smith, J. M. andCohen, R. J. (1984) Simple finite-element model accounts for wide range of cardiac dysrhythmias.Proc. Nat. Acad. Sci. USA,81, 233–237.
Spurrell, R. A. J. andSowton, E. (1976) An implanted atrial synchronous pacemaker with a short atrioventricular delay for the prevention of paroxysmal supraventricular tachycardia.J. Electrocardiol.,9, 89–96.
Wartak, J. (1970)Computers in electrocardiography. C.C. Thomas Co., Springfield, Illinois.
Zeigler, B. P. (1976)Theory of modelling and simulation. Wiley, New York.
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Malik, M., Cochrane, T., Davies, D.W. et al. Clinically relevant computer model of cardiac rhythm and pacemaker/heart interaction. Med. Biol. Eng. Comput. 25, 504–512 (1987). https://doi.org/10.1007/BF02441742
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DOI: https://doi.org/10.1007/BF02441742