Mark L. Trew

Weiwei Ai, Nitish Patel, Partha Roop et al.

Virtual heart models have been proposed to enhance the safety of implantable cardiac devices through closed loop validation. To communicate with a virtual heart, devices have been driven by cardiac signals at specific sites. As a result, only the action potentials of these sites are sensed. However, the real device implanted in the heart will sense a complex combination of near and far-field extracellular potential signals. Therefore many device functions, such as blanking periods and refractory periods, are designed to handle these unexpected signals. To represent these signals, we develop an intracardiac electrogram (IEGM) model as an interface between the virtual heart and the device. The model can capture not only the local excitation but also far-field signals and pacing afterpotentials. Moreover, the sensing controller can specify unipolar or bipolar electrogram (EGM) sensing configurations and introduce various oversensing and undersensing modes. The simulation results show that the model is able to reproduce clinically observed sensing problems, which significantly extends the capabilities of the virtual heart model in the context of device validation.

Eugene Yip, Sidharta Andalam, Partha S. Roop et al.

The heart is a vital organ that relies on the orchestrated propagation of electrical stimuli to coordinate each heart beat. Abnormalities in the heart's electrical behaviour can be managed with a cardiac pacemaker. Recently, the closed-loop testing of pacemakers with an emulation (real-time simulation) of the heart has been proposed. An emulated heart would provide realistic reactions to the pacemaker as if it were a real heart. This enables developers to interrogate their pacemaker design without having to engage in costly or lengthy clinical trials. Many high-fidelity heart models have been developed, but are too computationally intensive to be simulated in real-time. Heart models, designed specifically for the closed-loop testing of pacemakers, are too abstract to be useful in the testing of physical pacemakers. In the context of pacemaker testing, this paper presents a more computationally efficient heart model that generates realistic continuous-time electrical signals. The heart model is composed of cardiac cells that are connected by paths. Significant improvements were made to an existing cardiac cell model to stabilise its activation behaviour and to an existing path model to capture the behaviour of continuous electrical propagation. We provide simulation results that show our ability to faithfully model complex re-entrant circuits (that cause arrhythmia) that existing heart models can not.

Malitha Gunawardhana, Mark L Trew, Gregory B Sands et al.

Atrial Fibrillation (AF), the most common sustained cardiac arrhythmia worldwide, increasingly requires accurate bi-atrial structural assessment to guide ablation strategies, particularly in persistent AF. Late gadolinium-enhanced magnetic resonance imaging (LGE-MRI) enables visualisation of atrial fibrosis, but precise manual segmentation remains time-consuming, operator-dependent, and prone to variability. We propose TASSNet, a novel two-stage deep learning framework for fully automated segmentation of both left atrium (LA) and right atrium (RA), including atrial walls and cavities, from 3D LGE-MRI. TASSNet introduces two main innovations: (i) a ResNeXt-based encoder to enhance feature extraction from limited medical datasets, and (ii) a cyclical learning rate schedule to address convergence instability in highly imbalanced, small-batch 3D segmentation tasks. We evaluated our method on two datasets, one of which was completely out-of-distribution, without any additional training. In both cases, TASSNet successfully segmented atrial structures with high accuracy. These results highlight TASSNet's potential for robust and reproducible bi-atrial segmentation, enabling advanced fibrosis quantification and personalised ablation planning in clinical AF management.

Avinash Malik, Tommy Peng, Mark Trew

Invasive cardiac catheterisation is a common procedure that is carried out before surgical intervention. Yet, invasive cardiac diagnostics are full of risks, especially for young children. Decades of research has been conducted on the so called inverse problem of electrocardiography, which can be used to reconstruct Heart Surface Potentials (HSPs) from Body Surface Potentials (BSPs), for non-invasive diagnostics. State of the art solutions to the inverse problem are unsatisfactory, since the inverse problem is known to be ill-posed. In this paper we propose a novel approach to reconstructing HSPs from BSPs using a Time-Delay Artificial Neural Network (TDANN). We first design the TDANN architecture, and then develop an iterative search space algorithm to find the parameters of the TDANN, which results in the best overall HSP prediction. We use real-world recorded BSPs and HSPs from individuals suffering from serious cardiac conditions to validate our TDANN. The results are encouraging, in that coefficients obtained by correlating the predicted HSP with the recorded patient' HSP approach ideal values.

Avinash Malik, Partha S Roop, Sidharta Andalam et al.

Hybrid systems are discrete controllers that are used for controlling a physical process (plant) exhibiting continuous dynamics. A hybrid automata (HA) is a well known and widely used formal model for the specification of such systems. While many methods exist for simulating hybrid automata, there are no known approaches for the automatic code generation from HA that are semantic preserving. If this were feasible, it would enable the design of a plant-on-a-chip (PoC) system that could be used for the emulation of the plant to validate discrete controllers. Such an approach would need to be mathematically sound and should not rely on numerical solvers. We propose a method of PoC design for plant emulation, not possible before. The approach restricts input/output (I/O) HA models using a set of criteria for well-formedness which are statically verified. Following verification, we use an abstraction based on a synchronous approach to facilitate code generation. This is feasible through a sound transformation to synchronous HA. We compare our method (the developed tool called Piha) to the widely used Simulink R simulation framework and show that our method is superior in both execution time and code size. Our approach to the PoC problem paves the way for the emulation of physical plants in diverse domains such as robotics, automation, medical devices, and intelligent transportation systems.