A multi-way coupled model for the left-heart: Fluid-Structure-Electrophysiology interaction (FSEI).

During one day the human heart beats approximately 100,000 times. Each beat is triggered by specialized pacemaker cells that generate rhythmical electrical impulses rapidly propagating through the heart walls, stimulating myocytes contraction and, in turn, pumping blood. When this system functions normally the four heart chambers are well synchronized. In contrast, damages in the conductive system can alter the beating heart rhythm or modify the normal sequence of contraction of ventricles and atria thus reducing the pumping effectiveness.

In this study we present a computational model for unprecedented simulations of the left heart in physiological and pathological conditions. To this aim, a multi-way coupling between the network of conductive fibers (monodomain and bidomain models), the myocardium deformation (structural solver) and the produced hemodynamics (fluid solver) is needed. The resulting multi-physics model is then employed to study the physiological hemodynamics in the whole left heart, including atrium, aorta and ventricle with aortic/mitral valves. We also investigate how the heart pumping efficiency, in terms of ejection fraction and atrium/ventricle synchronization, is affected by a modification of the electrical conduction system or pacing location.