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SHR Neuro Cancer Cardio Lipid Metab Microb

Grandits, T; Gillette, K; Plank, G; Pezzuto, S.
Accurate and efficient cardiac digital twin from surface ECGs: Insights into identifiability of ventricular conduction system.
Med Image Anal. 2025; 105:103641 Doi: 10.1016/j.media.2025.103641
Web of Science PubMed FullText FullText_MUG

 

Leading authors Med Uni Graz

Gillette Karli

Grandits Thomas

Plank Gernot

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Abstract:

Digital twins for cardiac electrophysiology are an enabling technology for precision cardiology. Current forward models are advanced enough to simulate the cardiac electric activity under different pathophysiological conditions and accurately replicate clinical signals like torso electrocardiograms (ECGs). In this work, we address the challenge of matching subject-specific QRS complexes using anatomically accurate, physiologically grounded cardiac digital twins. By fitting the initial conditions of a cardiac propagation model, our non-invasive method predicts activation patterns during sinus rhythm. For the first time, we demonstrate that distinct activation maps can generate identical surface ECGs. To address this non-uniqueness, we introduce a physiological prior based on the distribution of Purkinje-muscle junctions. Additionally, we develop a digital twin ensemble for probabilistic inference of cardiac activation. Our approach marks a significant advancement in the calibration of cardiac digital twins and enhances their credibility for clinical application.

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