Pranav Bhagirath

215 General discussion Future perspectives Inverse potential mapping and simulations of cardiac activation are promising computational techniques for non-invasive assessment of rhythm disorders. Utilizing these tools for guidance of catheter ablation improves the procedural accuracy when compared to ablation using conventional mapping procedures. The computational model designed and investigated in this thesis, has been designed in a way that allows for instantaneous integration of patient-specific characteristics such as tissue properties (obtained using CMR). This integrated model offers the prospect to study the electrical activation in relation to tissue characteristics for complex (supra-)ventricular tachycardia and scar based arrhythmias. However, despite this drastic improvement in the possibilities to provide patient tailored therapy, there still remain factors that can cause discrepancies in the results of inverse potential mapping. In addition to the spatial displacement related to the movement of the ablation catheter, these include image misregistration due to patient respiration, inaccurate cardiac geometry due to image acquisition during different phases of the cardiac cycle and substantial regional variations in cardiac displacement during contraction and relaxation (ranging between 5-25 mm) 32, 33 . Especially the base of the heart moves 20 mm or more towards the apex. As this proposed model already utilizes CMR for the creation of the volume conductor model, future research should attempt to increase the accuracy of the inverse solution by incorporating movement correction and contractility related parameters derived from CINE images.