Computational modelling of cardiac ischaemia using a variable-order fractional Laplacian.

Heart failure is one of the most common causes of death in the western world. Many heart problems are linked to disturbances in cardiac electrical activity, such as wave re-entry caused by ischaemia. In terms of mathematical modelling, the monodomain equation is widely used to model electrical activity in the heart. Recently, Bueno-Orovio et al. [J. R. Soc. Interface 11: 20140352, 2014] pioneered the use of a fractional Laplacian operator in the monodomain equation to account for the complex heterogeneous structures in heart tissue. In this work we consider how to extend this approach to apply to hearts with regions of damaged tissue. This requires the use of a fractional Laplacian operator whose fractional order varies spatially. We develop efficient numerical methods capable of solving this challenging problem on domains ranging from simple one-dimensional intervals with uniform meshes, through to full three-dimensional geometries on unstructured meshes. Results are presented for several test problems in one dimension, demonstrating the effects of different fractional orders in regions of healthy and damaged tissue. Then we showcase some new results for a three-dimensional fractional monodomain equation with a Beeler-Reuter ionic current model on a rabbit heart mesh. These simulation results are found to exhibit wave re-entry behaviour, brought about only by varying the value of the fractional order in a region representing damaged tissue.