Related Experiment Video
Updated: Jan 11, 2026
Patient-specific Modeling of the Heart: Estimation of Ventricular Fiber Orientations
Published on: January 8, 2013
Validation of a Digital Twin Model for Three-Dimensional Noninvasive Functional Substrate Prediction in Scar Related
Matteo Parollo1, Niccolò Biasi2, Marco Torre1
1Second Division of Cardiology, Cardiothoracic and Vascular Department, Pisa University Hospital, Pisa, Italy.
Background:
High density electroanatomical mapping (EAM) is the standard for identifying functional substrate in scar-related ventricular tachycardia (VT), but it is limited by its two-dimensional nature and increased procedural complexity. Imaging-based strategies provide anatomical characterization but lack functional information. We evaluated a novel digital twin model (CardioMat) to non-invasively predict functional substrate in three-dimensions.
Objective:
To validate a novel digital twin model for noninvasive prediction of functional substrate in scar-related ventricular tachycardia.
Methods:
Fifteen patients with ischemic or nonischemic cardiomyopathy undergoing VT ablation were retrospectively analyzed. High-density EAM, cardiac magnetic resonance (CMR) post-processing with ADAS3D, and CardioMat modeling were performed. CardioMat-generated three-dimensional activation maps were integrated into the CARTO EAM suite. Deceleration zones (DZs) identified by CardioMat were compared with EAM-derived DZs and CMR-based heterogeneous tissue channels (HTCs) and scar areas.
Results:
A total of 255 cardiac segments were analyzed. CardioMat-derived DZs demonstrated high diagnostic accuracy (79% sensitivity, 93% specificity, 81% PPV, 92% NPV, 89% accuracy) for predicting EAM-DZ localization, outperforming CMR scar and HTCs. Multivariate analysis confirmed CardioMat DZs are the strongest independent predictor of EAM-DZ localization (OR 17.4, 95% CI 6.9-43.8, p > 0.001).
Conclusions:
This study provides preliminary evidence supporting the feasibility of a digital twin model for noninvasive functional substrate characterization. CardioMat integrates anatomical and functional information, outperforming conventional CMR-based assessment. Prospective multicenter validation is needed to establish its role in VT ablation guidance.
More Related Videos
06:57Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction
Published on: January 31, 2019
10:17Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System
Published on: April 11, 2025