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  • Matters Arising
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Reply to: Stochastic virtual heart model predictions

Nature Cardiovascular Research volume 4, pages 543–546 (2025)Cite this article

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The Original Article was published on 23 April 2025

replying to M. Bishop & G. Plank. Nat. Cardiovasc. Res. https://doi.org/10.1038/s44161-025-00641-1 (2025)

In a Matters Arising article1, Bishop & Plank raise concerns about our study2, suggesting that we might have overestimated the arrhythmogenicity of penetrating fat (infiltrating adipose tissue (inFAT)) in ischemic cardiomyopathy. The authors conclude that from numerical examination of propagation in a simple two-dimensional (2D) computational model that consists of a thin tissue channel surrounded completely by insulator, as a very simplified representation of electrical behavior in the human infarct zone. In this simplified representation, reentry is purely anatomical, with the thin conductive channel being the reentry isthmus. The authors demonstrate that propagation through this thin insulated channel, when the latter has remodeled electrophysiology (EP) representative of gray zone or fibro-fatty infiltrated myocardium can fail once the planar conduction velocity (CV) in the channel reaches low values (0.03–0.02 m s−1), over a range of spatial discretization values. In the exploration of numerical stability in this 2D model, there is a substantial source–sink mismatch at entrance and exit sites of the thin channel leading to a dramatic CV slowing there.

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Fig. 1: Distribution of scar/fat and border zones in 3D patient models and conduction velocities across model VT circuits.

Data availability

The original paper by Sung et al. provides a link to the repository of meshes and parameter files:

https://gitlab.com/natalia-trayanova/fat_infiltration_arrhythmias/-/tree/main?ref_type=heads

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Authors and Affiliations

  1. Alliance for Cardiovascular Diagnostic and Treatment Innovation, Johns Hopkins University, Baltimore, MD, USA

    Eric Sung, Adityo Prakosa & Natalia Trayanova

  2. Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA

    Eric Sung & Natalia Trayanova

Authors
  1. Eric Sung
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  2. Adityo Prakosa
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  3. Natalia Trayanova
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Contributions

E.S., A.P. and N.T. wrote this response.

Corresponding author

Correspondence to Natalia Trayanova.

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The authors declare no competing interests.

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Nature Cardiovascular Research thanks Blanca Rodriguez and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.

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Sung, E., Prakosa, A. & Trayanova, N. Reply to: Stochastic virtual heart model predictions. Nat Cardiovasc Res 4, 543–546 (2025). https://doi.org/10.1038/s44161-025-00642-0

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