Patient-specific generation of the Purkinje network driven by clinical measurement: the case of pathological propagations

To describe the electrical activity of the left ventricle is necessary to take into account the Purkinje fibers, responsible for the fast and coordinate ventricular activation, and their interaction with the muscular propagation. The aim of this work is to propose a methodology for the generation of a patient-specific Purkinje network driven by clinical measurements of the activation times acquired during pathological propagations. In particular, we consider clinical data acquired on four subjects suffering from pathologies with different origins, from conduction problems in the muscle or in the Purkinje fibers to a pre-excitation ventricular syndrome. To assess the accuracy of the proposed method, we compare the results obtained by using the patient-specific Purkinje network with the ones obtained by using a not patient-specific network. The results showed that the mean absolute errors are reduced by a factor in the range 27%-54%, highlighting the importance of including a patient-specific Purkinje network in computational models.