MioAtlas
3D-Koronar- und Ischämie-Atlas

3D-STEMI-Simulator: Koronarterritorien und OMI-Äquivalente

Visualisieren Sie die bioelektrischen und transmuralen Folgen eines akuten Koronarverschlusses am 3D-Herzmodell mit Standard- und Zusatzableitungen.

Coronary tree modeling & myocardial perfusion

The MioAtlas coronary engine reconstructs the three-dimensional architecture of the 11 major arterial branches over the ventricular epicardium: left main (LMCA), left anterior descending (LAD) with D1 and D2 diagonals, circumflex (LCx) with OM1 and OM2 marginals, and right coronary artery (RCA) with acute marginal (AM), posterior descending (PDA), and posterolateral (PLB) branches.

Each stenosis or occlusion point (parameter ter=...) defines an ischemic myocardium-at-risk volume based on vessel location and coronary dominance. Transmural injury is mapped onto the standardized AHA/ACC 17-segment model (Cerqueira et al. 2002). Cellular injury currents during depolarization and repolarization yield ST-vector shifts recorded on the live 120 Hz ECG monitor.

OMI paradigm: beyond strict millimeter criteria

The simulator integrates 8 ECG phenotypes reflecting the modern Occlusion Myocardial Infarction (OMI) paradigm. This framework recognizes that many acute transmural or critical subtotal occlusions do not meet traditional millimeter ST elevation thresholds in contiguous leads.

Modeled patterns include De Winter hyperacute T-waves in critical proximal LAD stenosis, Wellens biphasic/inverted T-wave reperfusion patterns (Types A and B), Aslanger inferior infarction with multivessel disease, giant Shark-Fin triangular waves, and modified Sgarbossa-Smith criteria in LBBB and ventricular pacing.

Biophysical variables: evolutionary phases & coronary dominance

ECG manifestations change dynamically with ischemic duration and coronary anatomy. The engine allows interactive selection of infarction phases (ph=HIPERAGUDA, AGUDA, ESTABLECIDA, SUBAGUDA, or CRONICA), demonstrating the progression from hyperacute T-waves to pathological Q-wave necrosis (>30 ms) and T-wave inversion.

Dominance settings (dom=RIGHT, LEFT, CODOMINANT) redistribute vascular supply to the inferior and posterior LV, altering whether maximum ST elevation appears in lead III (right dominant) or lead II with inferolateral involvement (left dominant).

Koronarbaum in 3D erkunden

Starten Sie den Simulator im Koronarmodus mit RIVA-Infarkt und passen Sie Territorium, Dominanz und Phase interaktiv an.

3D-Koronarsimulator öffnen

18 Koronarverschlussstellen (STEMI / Transmuraler Infarkt)

Anatomische Lokalisationen am Hauptstamm, RIVA, RCX, RCA und Sekundärästen.

Hauptstamm (LMS / LMCA)

1 location

RIVA / LAD (Ramus interventricularis anterior)

5 locations

RCX (Ramus circumflexus)

2 locations

RCA (Rechte Koronararterie)

4 locations

Koronare Seitenäste (Diagonal-, Marginaläste, RIVP, RPL)

6 locations
OMI-Paradigma

8 EKG-Phänotypen und OMI-Äquivalente

Hochriskante Ischämiemuster bei akutem Koronarverschluss ohne klassische Millimeter-Kriterien.

Hemodynamic and electrophysiological foundation

The 11-artery coronary model and myocardium-at-risk mapping build upon standardized American Heart Association anatomical classifications (Cerqueira et al. 2002; Austen et al. 1975). Culprit artery correlation and reciprocal leads follow European Society of Cardiology and American College of Cardiology consensus guidelines (Thygesen et al. 2018; Ibanez et al. 2018).

View full methodological specification → View ECG monitor technical documentation →