Personalized computer models of the hearts of patients who have suffered a heart attack can be used to assess the patients’ risk of developing a life-threatening irregularity in heart rhythm (arrhythmia), describes a new study in Nature Communications. These 3D computer models can identify at-risk patients who may then wish to obtain a surgical insertion of an implantable defibrillator.

Despite sudden cardiac death due to arrhythmia being a leading cause of death in the industrialized world, available approaches to identify at-risk patients do not account for patient-specific differences in heart geometry and are therefore limited in their therapeutic efficacy.

Natalia Trayanova and colleagues used clinical magnetic resonance images to make detailed computer models of the electrical activity and geometry of 41 individual hearts of patients who had experienced a heart attack. Through the combination of computations of the geometry of the muscular wall of the heart and of the degree of electrical instability in the heart, the authors were able to assess the propensity of each ‘virtual heart’ to develop arrhythmia. They tested their results retrospectively using available clinical data from the patients, and found that their approach significantly outperforms existing clinical metrics in predicting future life-threatening changes in heart rhythm.

Although this methodology has not yet been validated in an independent cohort of patients, the authors propose that this non-invasive, personalized risk assessment tool has the potential to prevent sudden cardiac death from arrhythmia and eliminate many unnecessary implantations of defibrillators.