We developed a novel patient-specific computational model for the numerical simulation of ventricular electromechanics in patients with ischemic cardiomyopathy (ICM). This model reproduces the activity both in sinus rhythm (SR) and in ventricular tachycardia (VT). The presence of scars, grey zones and non-remodeled regions of the myocardium is accounted for by the introduction of a spatially heterogeneous coefficient in the 3D electromechanics model. This 3D electromechanics model is firstly coupled with a 2-element Windkessel afterload model to fit the pressure-volume (PV) loop of a patient-specific left ventricle (LV) with ICM in SR. Then, we employ the coupling with a 0D closed-loop circulation model to analyze a VT circuit over multiple heartbeats on the same LV. We highlight similarities and differences on the solutions obtained by the electrophysiology model and those of the electromechanics model, while considering different scenarios for the circulatory system. We observe that very different parametrizations of the circulation model induce the same hemodynamical considerations for the patient at hand. Specifically, we classify this VT as unstable. We conclude by stressing the importance of combining electrophysiological, mechanical and hemodynamical models to provide relevant clinical indicators in how arrhythmias evolve and can potentially lead to sudden cardiac death.

我们开发了一种新的特定于患者的计算模型，用于对缺血性心肌病 (ICM) 患者的心室机电进行数值模拟。该模型再现了窦性心律 (SR) 和室性心动过速 (VT) 的活动。通过在 3D 机电模型中引入空间异质系数来解释心肌的疤痕、灰色区域和非重塑区域的存在。该 3D 机电模型首先与 2 元素 Windkessel 后负荷模型相结合，以拟合具有 SR 中 ICM 的患者特定左心室 (LV) 的压力-容积 (PV) 环。然后，我们使用与 0D 闭环循环模型的耦合来分析同一 LV 上多个心跳的 VT 电路。我们强调了电生理模型和机电模型获得的解决方案的异同，同时考虑了循环系统的不同场景。我们观察到循环模型的非常不同的参数化导致手头患者的相同血流动力学考虑。具体来说，我们将此 VT 归类为不稳定。最后，我们强调了结合电生理、机械和血流动力学模型的重要性，以提供有关心律失常如何演变并可能导致心源性猝死的相关临床指标。我们观察到循环模型的非常不同的参数化导致手头患者的相同血流动力学考虑。具体来说，我们将此 VT 归类为不稳定。最后，我们强调了结合电生理、机械和血流动力学模型的重要性，以提供有关心律失常如何演变并可能导致心源性猝死的相关临床指标。我们观察到循环模型的非常不同的参数化导致手头患者的相同血流动力学考虑。具体来说，我们将此 VT 归类为不稳定。最后，我们强调了结合电生理、机械和血流动力学模型的重要性，以提供有关心律失常如何演变并可能导致心源性猝死的相关临床指标。