Background: Experimental mapping and computer modelling provide important platforms to study the fundamental mechanisms underlying normal and abnormal activation of the heart. However, accurate computer modelling requires detailed anatomical models and needs support and validation from experimental data. Aims: 1) Construction of detailed anatomical heart models with the cardiac conduction system (CCS). 2) Mapping of the electrical activation sequence in rabbit atria to support and validate computer simulation. 3) Mapping of the spontaneous activity in the atrioventricular ring tissues (AV rings), which consist of nodal-like myocytes and can be a source of atrial tachycardia. Methods: High-resolution magnetic resonance imaging (MRI) and computed tomography (CT) were used to provide two-dimensional (2D) images for the construction of the detailed anatomical heart models. Immunohistochemistry and Masson’s trichrome staining were used to distinguish the CCS in the heart. LabVIEW was used in the development of a multi-electrode mapping system. The multi-electrode mapping technique was employed to map the electrical activation sequence of the rabbit atria. The cellular automaton model was used to simulate electrical activation of the rabbit atria. Results: 1) Three detailed anatomical models were constructed, including a detailed three dimensional (3D) anatomical model of the rabbit heart (whole of the atria and part of the ventricles), a 3D anatomical model of the rat heart with the CCS and AV rings, and a 3D anatomical model of the human atrioventricular node. 2) A multi-electrode mapping system was developed. 3) The electrical activation sequence of the rabbit atria was mapped in detail using the multi-electrode mapping system. The conduction velocity in the rabbit atria was measured. The mapping data showed the coronary sinus and the left superior vena cava do not provide an interatrial conduction route during sinus rhythm in the rabbit heart. 4) Electrical activation of the rabbit atria was simulated with the support of the 3D anatomical model of the rabbit atria and the experimental mapping data. 5) The spontaneous activity in the rat AV rings was mapped using the multi-electrode mapping system. Conclusions: The detailed anatomical models developed in this study can be used to support accurate computer simulation and can also be used in anatomical teaching and research. The experimental mapping data from the rabbit atria can be used to support and validate computer simulation. The computer simulation study demonstrated the importance of anatomical structure and electrophysiological heterogeneity. This study also demonstrated that the AV rings could potentially act as ectopic pacemakers.

Biomechanical factors influencing the reduction of dislocated hips with the Pavlik harness in patients of Developmental Dysplasia of the Hip (DDH) were studied using a simplified three-dimensional computer model simulating hip reduction dynamics in (1) subluxated, and (2) fully dislocated hip joints. The CT-scans of a 6 month-old female infant were used to measure the geometrical features of the hip joint including acetabular and femoral head diameter, acetabular depth, and geometry of the acetabular labrum, using the medical segmentation software Mimics. The lower extremity was modeled by three segments: thigh, leg, and foot. The mass and the location of the center of gravity of each segment were calculated using anthropometry, based on the total body mass of a 6-month old female infant at the 50th length-for-age percentile. A calibrated nonlinear stress-strain model was used to simulate muscle responses. The simplified 3D model consists of the pubis, ischium, acetabulum with labrum, and femoral head, neck, and shaft. It is capable of simulating dislocated as well as reduced hips in abduction and flexion. Five hip adductor muscles were identified as key mediators of DDH prognosis, and the non-dimensional force contribution of each in the direction necessary to achieve concentric hip reductions was determined. Results point to the adductor muscles as mediators of subluxated hip reductions, as their mechanical action is a function of the degree of hip dislocation. For subluxated hips in abduction and flexion, the Pectineus, Adductor Brevis, Adductor Longus, and proximal Adductor Magnus muscles contribute positively to reduction, while the rest of the Adductor Magnus contributes negatively. In full dislocations all muscles contribute detrimentally to reduction, elucidating the need for traction to reduce Graf IV type dislocations. Reduction of iv dysplastic hips was found to occur in two distinct phases: (a) release phase and (b) reduction phase. To expand the range of DDH-related problems that can be studied, an improved threedimensional anatomical computer model was generated by combining CT-scan and muscle positional data belonging to four human subjects. This model consists of the hip bone and femora of a 10-week old female infant. It was segmented to encompass the distinct cartilaginous regions of infant anatomy, as well as the different regions of cortical and cancellous bone; these properties were retrieved from the literature. This engineering computer model of an infant anatomy is being employed for (1) the development of a complete finite element and dynamics computer model for simulations of hip dysplasia reductions using novel treatment approaches, (2) the determination of a path of least resistance in reductions of hip dysplasia based on a minimum potential energy approach, (3) the study of the mechanics of hyperflexion of the hip as alternative treatment for late-presenting cases of hip dysplasia, and (4) a comprehensive investigation of the effects of femoral anteversion angle (AV) variations in reductions of hip dysplasia. This thesis thus reports on an interdisciplinary effort between orthopedic surgeons and mechanical engineers to apply engineering fundamentals to solve medical problems. The results of this research are clinically relevant in pediatric orthopaedics.