3D anatomical reconstruction of human cardiac conduction system and simulation of bundle branch block after TAVI procedure.

The cardiac conduction system (CCS) is responsible for the initiation and propagation of action potentials through the heart ensuring efficient pumping of blood. Understanding the anatomy of the CCS and its relationship with other major cardiac components is important to help understand arrhythmias and how certain procedures may increase the incidence of arrhythmias developing. We sectioned a whole human heart and performed Masson's trichrome histology in order to identify the components of the CCS. The histology images were used to construct a 3D anatomical model. We have shown that it is possible to create a 3D anatomical model of the human heart incorporating the CCS based on histological images, and that this model can be used to perform computer simulations of cardiac excitation. From the reconstruction we have been able to show the relative positions of the CCS components to each other. We have also shown how the close proximity of the CCS to the aortic valve can explain some of the conduction complications, such as left bundle branch block, that arise after aortic valve replacement procedures.