This book targets three fields of computational multi-scale cardiac modeling. First, advanced models of the cellular atrial electrophysiology and fiber orientation are introduced. Second, novel methods to create patient-specific models of the atria are described. Third, applications of personalized models in basic research and clinical practice are presented. The results mark an important step towards the patient-specific model-based atrial fibrillation diagnosis, understanding and treatment.

Parallel transmission enables control of the RF field in high-field Magnetic Resonance Imaging (MRI). However, the approach has also caused concerns about the specific absorption rate (SAR) in the patient body. The present work provides new concepts for SAR prediction. A novel approach for generating human body models is proposed, based on a water-fat separated MRI pre-scan. Furthermore, this work explores various approaches for SAR reduction.

Multiscale modeling of cardiac electrophysiology helps to better understand the underlying mechanisms of atrial fibrillation, acute cardiac ischemia and pharmacological treatment. For this purpose, measurement data reflecting these conditions have to be integrated into models of cardiac electrophysiology. Several methods for this model adaptation are introduced in this thesis. The resulting effects are investigated in multiscale simulations ranging from the ion channel up to the body surface. AbstractEnglisch = Multiscale modeling of cardiac electrophysiology helps to better understand the underlying mechanisms of atrial fibrillation, acute cardiac ischemia and pharmacological treatment. For this purpose, measurement data reflecting these conditions have to be integrated into models of cardiac electrophysiology. Several methods for this model adaptation are introduced in this thesis. The resulting effects are investigated in multiscale simulations ranging from the ion channel up to the body surface.

This work presents methods to advance electrophysiological simulations of intracardiac electrograms (IEGM). An experimental setup is introduced, which combines electrical measurements of extracellular potentials with a method for optical acquisition of the transmembrane voltage in-vitro. Thereby, intracardiac electrograms can be recorded under defined conditions. Using experimental and clinical signals, detailed simulations of IEGMs are parametrized, which can support clinical diagnosis.

This work provides methods to measure and analyze features of atrial electrograms - especially complex fractionated atrial electrograms (CFAEs) - mathematically. Automated classification of CFAEs into clinical meaningful classes is applied and the newly gained electrogram information is visualized on patient specific 3D models of the atria. Clinical applications of the presented methods showed that quantitative measures of CFAEs reveal beneficial information about the underlying arrhythmia.

This work is focused on different aspects within the loop of multiscale modeling: On the cellular level, effects of adrenergic regulation and the Long-QT syndrome have been investigated. On the organ level, a model for the excitation conduction system was developed and the role of electrophysiological heterogeneities was analyzed. On the torso level a dynamic model of a deforming heart was created and the effects of tissue conductivities on the solution of the forward problem were evaluated.

ECG recordings provide diagnostic relevant information on the de- and repolarisation sequences of the heart. A modification of the repolarisation sequence is assumed to cause Torsades de Pointes. Especially drug induced effects on the repolarisation processes are in focus, since some non-cardiac drugs have been associated with sudden cardiac death in the 1990s. The analysis of the ventricular repolarisation using a set of parameters depicting the morphology of the T-wave is introduced in this work. Therefore, new methods of fully automatic patient-specific QRS detection, beat classification and precise T-wave delineation are presented. Using these methods, medical studies are investigated regarding the modification of the T-wave by different compounds. Also the impact of the heart rate on the morphology of the T-wave is part of this research. The reliable identification of ventricular ectopic beats allows an analysis of the influence of these beats on subsequent heart beats. It turned out that the morphology of subsequent heart beats can significantly be changed. This might give new information on the proarrythmical risk of ventricular ectopic beats.

In this work, the physiological effects of time-varying magnetic fields up to 100 kHz have been investigated, namely magnetic stimulation and body warming. Simulation studies were based on numerical calculations on sophisticated cell and body models. In addition, magnetic stimulation thresholds have been determined experimentally. The project was carried out within the scope of the development of Magnetic Particle Imaging, a new imaging technology for medical diagnostics.