T. Fritz, C. Wieners, G. Seemann, H. Steen, and O. Dössel. Simulation of the contraction of the ventricles in a human heart model including atria and pericardium : Finite element analysis of a frictionless contact problem. In Biomechanics and Modeling in Mechanobiology, vol. 13(3) , pp. 627-641, 2014
During the contraction of the ventricles, the ventricles interact with the atria as well as with the pericardium and the surrounding tissue in which the heart is embedded. The atria are stretched, and the atrioventricular plane moves toward the apex. The atrioventricular plane displacement (AVPD) is considered to be a major contributor to the ventricular function, and a reduced AVPD is strongly related to heart failure. At the same time, the epicardium slides almost frictionlessly on the pericardium with permanent contact. Although the interaction between the ventricles, the atria and the pericardium plays an important role for the deformation of the heart, this aspect is usually not considered in computational models. In this work, we present an electromechanical model of the heart, which takes into account the interaction between ventricles, pericardium and atria and allows to reproduce the AVPD. To solve the contact problem of epicardium and pericardium, a contact handling algorithm based on penalty formulation was developed, which ensures frictionless and permanent contact. Two simulations of the ventricular contraction were conducted, one with contact handling of pericardium and heart and one without. In the simulation with contact handling, the atria were stretched during the contraction of the ventricles, while, due to the permanent contact with the pericardium, their volume increased. In contrast to that, in the simulations without pericardium, the atria were also stretched, but the change in the atrial volume was much smaller. Furthermore, the pericardium reduced the radial contraction of the ventricles and at the same time increased the AVPD.
Magnetic resonance imaging (MRI) is a valuable diagnostic method for many cardiovascular diseases. To date, patients with pacemakers are contra-indicated for cardiac MRI exams due to several effects that can occur during the MRI procedure: a) heating of the lead-tip, and b) less hazardous sensing errors and device malfunctions. Almost all measurements on MRI pacemaker compatibility have been conducted on classic 1.5 or 3T cylindrical whole-body MRI systems. In contrast, this study focused on the use of a high field open MRI (HFO) system due to its advantageous properties of RF fields which are commonly made responsible for the induction of lead heating.
As of today, the use of MRI procedures on patients with implanted cardiac pacemakers is prohibited due to safety issues. The implants can interact with the RF fields of the MRI device. The most hazardous effect is heating at the tip of the lead, less dangerous are sensing errors and malfunctions of the devices, because they disappear completely after the procedure. The majority of the previous studies used classic cylindrical whole-body MRI systems. The influence of different alignments of the pacemaker/lead system and the RF fields were evaluated by comparing temperature changes occurring in a cylindrical device with the effects induced in a high field open MRI (HFO) system.