Background
Cardiovascular diseases remain the leading cause of mortality worldwide. Pulsed field ablation (PFA), which uses irreversible electroporation to ablate arrhythmogenic tissue, has in recent years become established in clinical practice for the treatment of atrial fibrillation, the most common cardiac arrhythmia. Its application to ventricular arrhythmias, which are among the most life-threatening heart rhythm disorders, remains more challenging: it requires reliable lesion formation in the thicker ventricular myocardium and treatment planning adapted to the individual patient. In parallel, reversible electroporation offers opportunities for cardiac gene and cell therapy that offer potential for treatment of ischemic heart disease and heart failure.
Aim and objectives
CardioEP is a five-year interdisciplinary project that brings together more than 60 researchers from Slovenian institutions: four faculties of the University of Ljubljana (Faculty of Electrical Engineering, Faculty of Computer and Information Science, Faculty of Medicine, and Veterinary Faculty), the University Medical Centre Ljubljana, the Institute of Oncology Ljubljana, and the Jožef Stefan Institute. The project combines engineering, medicine, and artificial intelligence to develop electroporation-based therapies across a wide spectrum of cardiac diseases, from ventricular arrhythmias to heart failure. By integrating medical imaging, computational modeling, and translational validation from cells to clinical studies, the project develops personalized digital twin tools alongside novel gene and cell therapy approaches. The objectives are to:
- develop artificial intelligence methods, data infrastructure, and advanced magnetic resonance imaging (MRI) approaches to enable real-time prediction of electroporation outcomes in cardiac tissue, providing the computational foundation for digital twin-based personalization of electroporation treatments;
- develop personalized treatment protocols for ventricular arrhythmias using PFA, combining digital twin technology with cardiac imaging (computed tomography and MRI), electro-anatomical mapping, and numerical modeling to enable patient-specific treatment planning and real-time prediction of ablation outcomes;
- develop electroporation-based protocols for non-viral delivery of therapeutic nucleic acids into cardiac cells to promote cardiac muscle regeneration, validated in myocardial tissue slices and in small animal models in vivo;
- develop a personalized approach for treating heart failure that combines reversible electroporation with stem cell therapy to improve stem cell retention in the myocardium, validated in vitro and evaluated in a prospective randomized clinical study in patients with nonischemic dilated cardiomyopathy;
- establish Slovenia’s first large animal research facility for preclinical cardiac electrophysiology studies, enabling development and validation of electroporation-based treatments in pigs.
Expected outcomes
The expected results include machine learning models for real-time prediction of electroporation, an integrated data infrastructure, and advanced MRI sequences for monitoring electroporation in cardiac tissue; a digital twin framework with patient-specific numerical models and validated treatment planning protocols for ventricular PFA; optimized electroporation protocols for cardiac gene delivery and for enhanced stem cell retention, with preclinical validation in animal models and clinical evaluation in patients; and an operational large animal research facility with validated experimental models of cardiac arrhythmias and cardiomyopathies. A longer-term goal is to establish a Center for Clinical and Experimental Cardiac Electrophysiology in Ljubljana that will sustain the collaboration beyond the project period.
Project website: https://www.cardioep.vip/
Project details
| Principal investigator | Prof. Damijan Miklavčič |
|---|---|
| Role | Coordinator |
| Home institution | University of Ljubljana, Faculty of Electrical Engineering |
| Funder | Slovenian Research and Innovation Agency (ARIS) through University of Ljubljana’s internal funding for Large Interdisciplinary Research Projects |
| Start date | November 2025 |
| End date | October 2030 |
| Grant budget | EUR 2.375M (EUR 475,000 per year) |
| Participant institutions | University of Ljubljana, Faculty of Electrical Engineering, Slovenia University of Ljubljana, Faculty of Medicine, Slovenia University of Ljubljana, Faculty of Computer and Information Science, Slovenia University of Ljubljana, Veterinary Faculty, Slovenia University Medical Centre Ljubljana, Slovenia Institute of Oncology Ljubljana, Slovenia Jožef Stefan Institute, Slovenia |