Hybrid modeling of electrical and optical behavior in the heart

Optical mapping of transmembrane potential using voltage-sensitive dyes has revolutionized cardiac electrophysiology by enabling the visualization of electrical excitation waves in the heart. However, the interpretation of the optical mapping data is complicated by the fact that the optical signal arises not just from the surface, but also from some depth into the heart wall. Here, we review modeling efforts, in which the diffusion of photons is incorporated into the computer simulations of cardiac electrical activity (“hybrid” modeling), with the goal of improving our understanding of optical signals. We discuss the major accomplishments of hybrid modeling which include: (i) the explanation of the optical action potential upstroke morphology and prediction of its dependence on the subsurface wave front angle, (ii) the unexpectedly low magnitudes of optically recorded surface potentials during electrical shocks, and (iii) the “depolarization” of the core of the spiral wave and odd dual-humped optical action potentials during reentrant activation. We critically examine current optical mapping techniques and controversies in our understanding of electroporation during defibrillation. Finally, we provide a brief overview of recent theoretical studies aimed at extending optical mapping techniques for imaging intramural excitation to include transillumination imaging of scroll wave filaments and depth-resolved optical tomographic methods.