Gernot Plank

Gernot Plank
Medical University of Graz · Institute of Biophysics

MS PhD

About

360
Publications
34,436
Reads
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7,043
Citations
Citations since 2016
162 Research Items
4249 Citations
20162017201820192020202120220200400600800
20162017201820192020202120220200400600800
20162017201820192020202120220200400600800
20162017201820192020202120220200400600800
Additional affiliations
September 2018 - present
Medical University of Graz
Position
  • Professor
October 2013 - present
Karl-Franzens-Universität Graz
Position
  • Lecturer
April 2010 - present
Medical University of Graz
Position
  • Professor (Associate)

Publications

Publications (360)
Preprint
Full-text available
Mechanistic cardiac electrophysiology models allow for personalized simulations of the electrical activity in the heart and the ensuing electrocardiogram (ECG) on the body surface. As such, synthetic signals possess known ground truth labels of the underlying disease and can be employed for validation of machine learning ECG analysis tools in addit...
Article
Full-text available
Aims Existing strategies that identify post-infarct ventricular tachycardia (VT) ablation target either employ invasive electrophysiological (EP) mapping or non-invasive modalities utilizing the electrocardiogram (ECG). Their success relies on localizing sites critical to the maintenance of the clinical arrhythmia, not always recorded on the 12-lea...
Article
Full-text available
Previous patient-specific model calibration techniques have treated each patient independently, making the methods expensive for large-scale clinical adoption. In this work, we show how we can reuse simulations to accelerate the patient-specific model calibration pipeline. To represent anatomy, we used a Statistical Shape Model and to represent fun...
Article
The field of cardiac electrophysiology tries to abstract, describe and finally model the electrical characteristics of a heartbeat. With recent advances in cardiac electrophysiology, models have become more powerful and descriptive as ever. However, to advance to the field of inverse electrophysiological modeling, i.e. creating models from electric...
Article
Full-text available
Computer models capable of representing the intrinsic personal electrophysiology (EP) of the heart in silico are termed virtual heart technologies. When anatomy and EP are tailored to individual patients within the model, such technologies are promising clinical and industrial tools. Regardless of their vast potential, few virtual technologies simu...
Article
Full-text available
A significant number of right bundle branch block (RBBB) patients receive cardiac resynchronization therapy (CRT), despite lack of evidence for benefit in this patient group. His bundle (HBP) and left bundle pacing (LBP) are novel CRT delivery methods, but their effect on RBBB remains understudied. We aim to compare pacing-induced electrical synchr...
Article
Full-text available
Computational models have made it possible to study the effect of fibrosis and scar on atrial fibrillation (AF) and plan future personalized treatments. Here, we study the effect of area available for fibrillatory waves to sustain AF. Then we use it to plan for AF ablation to improve procedural outcomes. CARPentry was used to create patient-specifi...
Article
Full-text available
The bidomain model and the finite element method are an established standard to mathematically describe cardiac electrophysiology, but are both suboptimal choices for fast and large-scale simulations due to high computational costs. We investigate to what extent simplified approaches for propagation models (monodomain, reaction-Eikonal and Eikonal)...
Article
Full-text available
We propose FiberNet, a method to estimate in-vivo the cardiac fiber architecture of the human atria from multiple catheter recordings of the electrical activation. Cardiac fibers play a central role in the electro-mechanical function of the heart, yet they are difficult to determine in-vivo, and hence rarely truly patient-specific in existing cardi...
Article
Full-text available
A key factor governing the mechanical performance of the heart is the bidirectional coupling with the vascular system, where alterations in vascular properties modulate the pulsatile load imposed on the heart. Current models of cardiac electromechanics (EM) use simplified 0D representations of the vascular system when coupling to anatomically accur...
Chapter
While mitochondrial dysfunction has been implicated in the pathogenesis of cardiac arrhythmias, how the abnormality occurring at the organelle level escalates to influence the rhythm of the heart remains incompletely understood. This is due, in part, to the complexity of the interactions formed by cardiac electrical, mechanical, and metabolic subsy...
Article
Full-text available
Fiber-reinforced soft biological tissues are typically modeled as hyperelastic, anisotropic, and nearly incompressible materials. To enforce incompressibility a multiplicative split of the deformation gradient into a volumetric and an isochoric part is a very common approach. However, the finite element analysis of such problems often suffers from...
Article
Full-text available
Image-based computational models of the heart represent a powerful tool to shed new light on the mechanisms underlying physiological and pathological conditions in cardiac function and to improve diagnosis and therapy planning. However, in order to enable the clinical translation of such models, it is crucial to develop personalized models that are...
Article
Background Thresholding based analysis of late gadolinium enhancement cardiac MRI (LGE-CMR) can create scar maps and identify corridors that might provide a reentrant substrate for ventricular tachycardia (VT). Current recommendations employ a full-width-at-half-maximum approach, effectively classifying areas with a pixel-signal-intensity (PSI) >40...
Article
Full-text available
Catheter ablation is currently the only curative treatment for scar-related ventricular tachycardias (VTs). However, not only are ablation procedures long, with relatively high risk, but success rates are punitively low, with frequent VT recurrence. Personalized in-silico approaches have the opportunity to address these limitations. However, state-...
Article
Full-text available
Application of epicardial patches constructed from human-induced pluripotent stem cell- derived cardiomyocytes (hiPSC-CMs) has been proposed as a long-term therapy to treat scarred hearts post myocardial infarction (MI). Understanding electrical interaction between engineered heart tissue patches (EHT) and host myocardium represents a key step towa...
Article
Full-text available
Computational Fluid Dynamics (CFD) is used to assist in designing artificial valves and planning procedures, focusing on local flow features. However, assessing the impact on overall cardiovascular function or predicting longer-term outcomes may require more comprehensive whole heart CFD models. Fitting such models to patient data requires numerous...
Article
Cardiac fiber direction is an important factor determining the propagation of electrical activity, as well as the development of mechanical force. In this paper, we imaged the ventricles of several species with special attention to the intraventricular septum to determine the functional consequences of septal fiber organization. First, we identify...
Preprint
Full-text available
Objective: The bidomain model and the finite element method are an established standard to mathematically describe cardiac electrophysiology, but are both suboptimal choices for fast and large-scale simulations due to high computational costs. We investigate to what extent simplified approaches for propagation models (monodomain, reaction-eikonal a...
Article
Full-text available
Personalised computer models of cardiac function, referred to as cardiac digital twins, are envisioned to play an important role in clinical precision therapies of cardiovascular diseases. A major obstacle hampering clinical translation involves the significant computational costs involved in the personalisation of biophysically detailed mechanisti...
Article
Full-text available
The aim of this study was to describe the morphology of the cavotricuspid isthmus (CTI) in detail and introduce a comprehensive scheme to describe the topology of this region based on functional considerations. This may lead to a better understanding of isthmus-dependent flutter and fibrillation and to improved intervention strategies. We used imag...
Preprint
Full-text available
We propose FiberNet, a method to estimate in-vivo the cardiac fiber architecture of the human atria from multiple catheter recordings of the electrical activation. Cardiac fibers play a central rolein the electro-mechanical function of the heart, yet they aredifficult to determine in-vivo, and hence rarely truly patient-specificin existing cardiac...
Preprint
Full-text available
The field of cardiac electrophysiology tries to abstract, describe and finally model the electrical characteristics of a heartbeat. With recent advances in cardiac electrophysiology, models have become more powerful and descriptive as ever. However, to advance to the field of inverse electrophysiological modeling, i.e. creating models from electric...
Article
Full-text available
Computer models of cardiac electro-mechanics (EM) show promise as an effective means for the quantitative analysis of clinical data and, potentially, for predicting therapeutic responses. To realize such advanced applications methodological key challenges must be addressed. Enhanced computational efficiency and robustness is crucial to facilitate,...
Preprint
Full-text available
Computational Fluid Dynamics (CFD) is used to assist in designing artificial valves and planning procedures, focusing on local flow features. However, assessing the impact on overall cardiovascular function or predicting longer-term outcomes may require more comprehensive whole heart CFD models. Fitting such models to patient data requires numerous...
Preprint
Full-text available
The impact of increased stiffness and pulsatile load on the circulation and their influence on heart performance have been documented not only for cardiovascular events but also for ventricular dysfunctions. For this reason, computer models of cardiac electromechanics (EM) have to integrate effects of the circulatory system on heart function to be...
Article
Full-text available
Lead position is an important factor in determining response to Cardiac Resynchronization Therapy (CRT) in dyssynchronous heart failure (HF) patients. Multipoint pacing (MPP) enables pacing from multiple electrodes within the same lead, improving the potential outcome for patients. Virtual quadripolar lead designs were evaluated by simulating pacin...
Article
Full-text available
Background Computational models of the heart built from cardiac MRI and electrophysiology (EP) data have shown promise for predicting the risk of and ablation targets for myocardial infarction (MI) related ventricular tachycardia (VT), as well as to predict paced activation sequences in heart failure patients. However, most recent studies have reli...
Article
Full-text available
Simulating the interaction of fluids with immersed moving solids is playing an important role for gaining a better quantitative understanding of how fluid dynamics is altered by the presence of obstacles and, vice versa, which forces are exerted on the solids by the moving fluid. Such problems appear in various contexts, ranging from numerous techn...
Preprint
Full-text available
Fiber-reinforced soft biological tissues are typically modeled as hyperelastic, anisotropic, and nearly incompressible materials. To enforce incompressibility a multiplicative split of the deformation gradient into a volumetric and an isochoric part is a very common approach. However, due to the high stiffness of anisotropic materials in the prefer...
Conference Paper
Fiber structure governs the spread of excitation in the heart; however, little is known about the effects of physiological variability in fiber orientation on epicardial activation. To investigate these effects, we implemented ventricular simulations of activation using rule-based fiber orientations, and robust uncertainty quantification algorithms...
Article
Background: Cardiac Resynchronization Therapy (CRT) in dyssynchronous heart failure patients is ineffective in 20-30% of cases. Sub-optimal left ventricular (LV) pacing location can lead to non-response, thus there is interest in LV lead location optimization. Invasive acute haemodynamic response (AHR) measurements have been used to optimize the L...
Article
Introduction Accurate reconstruction of cardiac activation wavefronts is crucial for clinical diagnosis, management, and treatment of cardiac arrhythmias. Furthermore, reconstruction of activation profiles within the intramural myocardium has long been impossible because electrical mapping was only performed on the endocardial surface. Recent advan...
Preprint
Full-text available
Catheter ablation is currently the only curative treatment for scar-related ventricular tachycardias (VTs). However, not only are ablation procedures long, with relatively high risk, but success rates are punitively low, with frequent VT recurrence. Personalized in-silico approaches have the opportunity to address these limitations. However, state-...
Article
Full-text available
Personalized models of cardiac electrophysiology (EP) that match clinical observation with high fidelity, referred to as cardiac digital twins (CDTs), show promise as a tool for tailoring cardiac precision therapies. Building CDTs of cardiac EP relies on the ability of models to replicate the ventricular activation sequence under a broad range of c...
Article
Full-text available
Cardiac digital twins (Cardiac Digital Twin (CDT)s) of human electrophysiology (Electrophysiology (EP)) are digital replicas of patient hearts derived from clinical data that match like-for-like all available clinical observations. Due to their inherent predictive potential, CDTs show high promise as a complementary modality aiding in clinical deci...
Article
Full-text available
Background: Focal ventricular tachycardia (VT) is a life-threating arrhythmia, responsible for high morbidity rates and sudden cardiac death (SCD). Radiofrequency ablation is the only curative therapy against incessant VT; however, its success is dependent on accurate localization of its source, which is highly invasive and time-consuming. Objectiv...
Chapter
Full-text available
Electroanatomical maps are a key tool in the diagnosis and treatment of atrial fibrillation. Current approaches focus on the activation times recorded. However, more information can be extracted from the available data. The fibers in cardiac tissue conduct the electrical wave faster, and their direction could be inferred from activation times. In t...
Chapter
Cardiac output is dependent on the tight coupling between atrial and ventricular function. The study of such interaction mechanisms is hindered by their complexity, and therefore requires a systematic approach. We have developed a four-chamber closed-loop cardiac electromechanics model which, through the coupling of the chambers with a closed-loop...
Article
Full-text available
Background and objective: Cardiac electrophysiology is a medical specialty with a long and rich tradition of computational modeling. Nevertheless, no community standard for cardiac electrophysiology simulation software has evolved yet. Here, we present the openCARP simulation environment as one solution that could foster the needs of large parts o...
Article
Full-text available
The identification of the initial ventricular activation sequence is a critical step for the correct personalization of patient-specific cardiac models. In healthy conditions, the Purkinje network is the main source of the electrical activation, but under pathological conditions the so-called earliest activation sites (EASs) are possibly sparser an...
Article
Full-text available
Cardiac anatomy plays a crucial role in determining cardiac function. However, there is a poor understanding of how specific and localised anatomical changes affect different cardiac functional outputs. In this work, we test the hypothesis that in a statistical shape model (SSM), the modes that are most relevant for describing anatomy are also most...
Article
Full-text available
In certain cardiac conduction system pathologies, like bundle branch block, block may be proximal, allowing for electrical stimulation of the more disal His bundle to most effectively restore activation. While selective stimulation of the His bundle is sought, surrounding myocardium may also be excited, resulting in nonselective pacing. The myocard...
Article
Full-text available
Objective: In this study, we have used whole heart simulations parameterized with large animal experiments to validate three techniques (two from the literature and one novel) for estimating epicardial and volumetric conduction velocity (CV). Methods: We used an eikonal-based simulation model to generate ground truth activation sequences with pr...
Article
Aims Electric conduction in the atria is direction-dependent, being faster in fibre direction, and possibly heterogeneous due to structural remodelling. Intracardiac recordings of atrial activation may convey such information, but only with high-quality data. The aim of this study was to apply a patient-specific approach to enable such assessment e...
Preprint
Full-text available
Background and Objective Cardiac electrophysiology is a medical specialty with a long and rich tradition of computational modeling. Nevertheless, no community standard for cardiac electrophysiology simulation software has evolved yet. Here, we present the openCARP simulation environment as one solution that could foster the needs of large parts of...
Article
Full-text available
Introduction Acute myocardial ischemia occurs when coronary perfusion to the heart is inadequate, which can perturb the highly organized electrical activation of the heart and can result in adverse cardiac events including sudden cardiac death. Ischemia is known to influence the ST and repolarization phases of the ECG, but it also has a marked effe...
Preprint
Full-text available
Electroanatomical maps are a key tool in the diagnosis and treatment of atrial fibrillation. Current approaches focus on the activation times recorded. However, more information can be extracted from the available data. The fibers in cardiac tissue conduct the electrical wave faster, and their direction could be inferred from activation times. In t...