Within SimCardioTest, three use cases will be studied to run in-silico trials and exploit the large data generated by the simulations. The first use case Pacing devices and leads is designed by University of Bordeaux, the second one The Left atrial appendage occluder developed at Universitat Pompeu Fabra, and the last one Drugs, efficacy and toxicity is led by Universitat Politècnica de València. SimCardioTest is integrating these use cases in an unified cloud-based platform where standardized approach for computer model will be developed.

Pacing devices and leads

Coronaire and cardiac stucture, @IHU Lyric

The first case on pacing devices will set up case-studies for in-silico simulation of catheterisation, implantation and pacing of cardiac devices, as a potential support to their development or certification. These use cases will cover the catheter navigation, the pacing performance and the mechanical risks, including perforation and fatigue. It will leverage a physical simulator using 3D printing, soft robotics, experimental data acquisition, and computer simulations in order to help the design and validation of such devices. We will make use of computational tools and expertise developed at Sofa (Simulation open Framework Architecture), and the Cardiac Electrophysiology Solver (CEPS) and use industrial catheters and pacing devices. The aim is to develop computational models of the navigation approaches, the computational evaluation of the pacing properties, and ultimately mechanical interaction (i.e., more specifically on perforation and fatigue). This will impact the design and the material on mechanical interactions, and will provide the best practical threshold and impedance for electrical performance.  

The left atrial appendage occluder

The Left atrial appendage occluder (LAAO) covers in-silico fluid simulations, that are already a pre-requisite in validation & certification of stents. Nevertheless, fluid simulations including more complex medical devices such as implantable devices were not mature enough until recently for being part of regulatory submissions. For LAAO devices, fluid simulations need common standards, best practices, sensitivity analyses and model calibration to determine the optimal set of boundary conditions to match experimental results. A robust computational pipeline to process the large amount of data required for in-silico clinical trials will also be developed. We will model the whole cycle of care of these patients, including models of thrombus formation and drug treatment, for better patient selection, device setting personalisation and prediction of treatment response.

VIDAA platform (UPF) for pre-interventional planing of LAAO implantation (Watchman device, BSC, in purple). Used to personalise LAAO device settings for an individual LAA @UPF

The drugs, efficacy and toxicity

Ischemia simulation @UPV

The Drugs, efficacy and toxicity will develop models for drug-ion channel interaction taking into consideration the plasmatic concentrations derived from pharmacokinetic and pharmacodynamic studies. The models will be used to analyse the effects of drugs at a multi-scale level from cell to organ, in normal and pathological conditions, such as ischemia, heart failure or atrial fibrillation.
Personalised models will be built according to standardisation process, populations of models where variability will be considered, as well as differences in gender and age. Specific biomarkers to assess drug efficacy and safety will be defined. 

Video @Inria:  SimCardioTest Science based content