Cardiac Simulation for Stroke Risk Assessment
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Solution Overview
Problem
Current methods for assessing stroke risk in atrial fibrillation patients are inadequate, particularly for subclinical cases and those with a low CHA2DS2-VASC score, as they fail to accurately predict thrombi formation in the left atrial appendage and do not account for individual variations in cardiac anatomy and function.
Innovation Solution
A computerized cardiac simulation system that uses three-dimensional cardiac images to model the left atrium and simulate blood flow over a cardiac cycle, employing computational fluid dynamics to provide personalized risk assessments and treatment planning by analyzing structural functions and blood flow dynamics.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If CHA2DS2-VASC scoring system is used for stroke risk assessment, then treatment guidelines are simplified, but measurement precision of individual stroke risk is reduced
Solution Approach 1:
The patent replaces the mechanical scoring system (CHA2DS2-VASC) with a computational fluid dynamics-based simulation system that models blood flow dynamics. This substitution enables precise, individualized stroke risk assessment by capturing complex hemodynamic parameters that cannot be quantified by simple scoring, thereby resolving the contradiction between ease of operation and measurement precision.
Solution Approach 2:
The invention transitions from static demographic parameters (age, sex, comorbidities) to dynamic hemodynamic parameters (blood flow velocity, pressure gradients, flow patterns). This parameter change enables accurate assessment of individual stroke risk while maintaining clinical utility through visualizable flow maps and quantitative metrics.
2Reliability
If oral anticoagulation is prescribed to all AF patients with CHA2DS2-VASC score ≥2, then stroke prevention is improved, but loss of substance through unnecessary medication increases
Solution Approach 1:
The patent implements feedback by using patient-specific blood flow simulation results to guide anticoagulation decisions. The system provides individualized stroke risk assessment that feeds back into treatment selection, enabling clinicians to prescribe anticoagulation only when hemodynamic analysis indicates genuine thrombus formation risk, thereby preventing both strokes and unnecessary medication exposure.
Solution Approach 2:
The invention performs preliminary hemodynamic assessment through blood flow simulation before initiating anticoagulation therapy. This preliminary action identifies patients who truly need anticoagulation based on their flow patterns and thrombus risk, preventing unnecessary medication exposure while ensuring appropriate treatment for high-risk individuals.
3Object-affected harmful factors
If LAA closure devices are used for patients who cannot tolerate AC, then bleeding risk is reduced, but device complexity and procedural invasiveness increase
Solution Approach 1:
The patent performs preliminary blood flow simulation to assess whether LAA closure is likely to be beneficial before subjecting patients to invasive procedures. This preliminary action uses non-invasive imaging and CFD analysis to predict thrombus risk reduction, enabling informed decision-making about whether the complexity of device implantation is justified for each individual patient.
4Measurement precision
If detailed blood flow simulation is performed for each patient, then measurement precision of stroke risk is improved, but loss of time for assessment increases
Solution Approach 1:
The patent performs preliminary screening using standard imaging protocols to identify patients who would benefit from detailed blood flow simulation. This preliminary action filters the patient population, applying comprehensive CFD analysis only to those with intermediate or uncertain risk, thereby reducing overall assessment time while maintaining high measurement precision for patients who need it.
Solution Approach 2:
The invention implements a tiered assessment approach where not all patients receive full detailed simulation. Instead, it applies partial assessment (standard imaging and scoring) to low-risk patients and excessive/detailed assessment (full CFD simulation) only to those who need precise risk stratification, optimizing the balance between measurement precision and time investment.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
This approach improves the accuracy of stroke risk stratification by accounting for individual patient anatomy and function, potentially reducing unnecessary anticoagulation and identifying patients who may benefit from left atrial appendage closure, thereby minimizing cerebrovascular events.
Implementation Method 1
modeling blood flow, using the computer, within, into and out of the left atrium of the subject as a function of time using computational fluidic dynamics
Data Source
AI summary
The present application relates to systems and methods for performing a computerized cardiac simulation for at least one of diagnosis, risk assessment or treatment planning including: receiving, by a computer, a plurality of three-dimensional cardiac images of a subject's heart such that each three-dimensional cardiac image corresponds to a different phase of a single cardiac cycle of the subject's heart; modeling structure, using the computer, of the left atrium of the subject as a function of time using the plurality of three-dimensional cardiac images of the subject's heart; modeling blood flow, using the computer, within, into and out of the left atrium of the subject as a function of time using computational fluidic dynamics and using structure of said left atrium obtained from at least one of said plurality of three-dimensional cardiac images or said modeling structure of said left atrium; simulating at least one of time dependent structural function or time-dependent blood flow of said left atrium using results from said modeling structure and said modeling blood flow for a selected period of time; and providing information to a user from said simulating for use in at least one of diagnosis, risk assessment or treatment planning for a physiological effect related to function of said left atrium of the subject.