Simulink Heart Model for Simulation of the Effect of
External Signals
Maxim Ryzhii and Elena Ryzhii
University of Aizu
Aizu-Wakamatsu, Japan
m-ryzhii @ieee.org
Abstract—In this work, we propose an extended
MATLAB/Simulink version of heterogeneous oscillator heart
model for simulation of the effect of applied external high-
frequency stimulation on the cardiac conduction system and
demonstrate some simulation results applying signals with
different amplitude, frequency and duration. Using the model we
observe reversible and irreversible conduction blocks as well as
initiation and termination of atrial and ventricular fibrillations.
The proposed model can be used for research, educational and
testing purposes.
Keywords—ECG; heart model; HF stimulation; oscillator; van
der Pol; FitzHugh-Nagumo; MATLAB/Simulink
I. INTRODUCTION
In order to find a potentially safer alternative to treat
ventricular fibrillation, many papers (see, for example [1-4])
are dedicated to the application of AC signal to myocardial
cells. Existing models of cardiac myocytes' dynamics including
multi-variable transient current require a lot of time and
computational resources [5].
Recently, we proposed a simple oscillator model of cardiac
conduction system based on set of heterogeneous oscillators
including main pacemakers and heart muscles [6]. Natural
pacemakers - sinoatrial node (SA), atrioventricular node (AV)
and His–Purkinje system (HP) - are represented by modified
Van der Pol type oscillators. The depolarization and
repolarization processes in atrial (AT) and ventricular (VN)
muscles, are described by modified FitzHugh-Nagumo
equations.
Resulting dynamic combined response of the oscillator
system is obtained in the clinically comparable form of the
synthetic electrocardiogram (ECG). The model allows
reproducing a number of various normal and pathological
situations including arrhythmias [7].
Different biologically inspired waveform generators were
proposed and realized for research, commercial and military
application (see, for example [8], and references wherein). The
utilization of the Simulink toolbox for analysis of the models
behavior and functionality gives an opportunity to create a real
hardware electronic implementation.
In this work we extended our model [6] in order to simulate
the effect of external high-frequency stimulation on the cardiac
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natural pacemakers and muscles. The extended model is
developed in MATLAB/Simulink which is able to reduce
calculation efforts and provides a relatively easy-to-use and
versatile simulation environment for study basic aspects of
cardiac dynamics in comparison with the classical approach.
To demonstrate the capability of our model, we consider its
behavior under periodic electrical stimulation caused by
applied sinusoidal signals with frequencies much higher than
natural cardiac rhythms.
With the proposed model we observed the ability of the AC
stimulations applied to natural pacemakers to produce
reversible and irreversible cardiac conduction blocks. The
appearance of the conduction blocks depends on the duration,
amplitude and frequency of the applied signal. The electrically
controlled conduction blocks may yield a novel approach for
study and treatment of cardiac arrhythmias [1, 2].
We also applied sinusoidal stimuli to AT and VN muscles
and successfully obtained corresponding quasi fibrillations.
This model in Simulink environment is intended to
facilitate the study of global behavior of cardiac conduction
system and the interaction between natural pacemakers,
pacemakers and muscles, and response of the system on
different external actions. The proposed model can be
considered as an intermediate step to the development of the
hardware electronic ECG simulator for education and testing
purposes as well.
II. MODEL
General block diagram of the Simulink implementation of
the heart model is shown in Fig. 1. As in our recent cardiac
oscillator model [6, 7], the pacemakers are described by sets of
modified van der Pol equations [9-11]
x' i = y i
y ' i = −a i y i ( xi2 − u 2 ) − Fi xi ( xi + d )( xi + ei ) (1)
+ K node ( xi −1 − xi ),
where index i = 1…3 corresponds to SA, AV, and HP nodes,
respectively, Knode denotes particular coupling coefficient for
each pacemaker (KSA, KAV, and KHP). The Simulink block
diagram for a natural pacemaker is shown in Fig. 2. Similar to
[7] we do not use delays in coupling terms, since the suitable
delays appear naturally in the system with proper Knode values.
 Fig. 1. General block diagram of the Simulink heart model. Open circles denote the places where ectopic pacemaker block was inserted for induction of
atrial and ventricular fibrillations (see Fig. 5).

Fig. 2. Block diagram of Simulink model for a natural pacemaker (modified van der Pol oscillator).

Fig. 3. Block diagram of Simulink model for depalarization and repolarization waves (modified FitzHugh-Nagumo oscillator).

The AT and VN muscles depolarization and repolarization
responses are described by modified FitzHugh-Nagumo type
equations [6]
z ' j = k j (−c j z j ( z j − w1 j )( z j − w2 j )
− b jv j − g jv j z j + I j )
v' j = k j h j ( z j − v j ).
Here index j = 1…4 refers to P wave, Ta wave, QRS complex,
and T wave oscillator blocks, respectively. The corresponding
Simulink block for a single oscillator representing
depolarization/repolarization wave in cardiac muscles is shown
in Fig. 3.
The synthetic net ECG signal is calculated as a composition
of muscle electrical responses in the following way:
(2) ECG = z1 − z2 + z3 + z4 , (3)
where z1 – z4 are the voltage depolarization and repolarization
signals from AT and VN muscle blocks (see Fig. 1). The
saturation elements placed between the outputs of SA and HP
pacemakers and inputs of muscle blocks play the role of

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 (a) (b)

Fig. 7. Simulated response on AC signal with amplitude A = 400, frequency

ω = 150 rad/sec, pulse width 1.5 sec, started from 5.0 sec. Irreversible
cardiac block.

Fig. 4. Scheme of application of external

signal Iext to the pacemakers: (a)
sinusoidal pulse generator added the
system on Fig. 1, and (b) addition of
second input In2 to a pacemaker block
shown in Fig. 2.

Fig. 8. Same as in Fig. 7, but with A = 300. Reversible cardiac block.

Fig. 5. Simulink block for application of EP signal IEP to muscles.

Fig. 9. Same as in Fig. 7, but with pulse width 1.0 sec. Reversible cardiac
block.

Fig. 10. Same as in Fig. 7, but with ω =180 rad/sec. Reversible cardiac
block.

Fig. 6. Pacemaker (SA, AV, and HP, top) signals, calculated ECG
(middle) at normal rhytm 70 bpm without application of an AC signal, and
real normal ECG (bottom) [12].

separation of positive (with “+” sign, for depolarization waves
– P and QRS complex) and negative (with “-“ sign, for
repolarization waves – Ta and T waves) parts of stimulation
currents produced by corresponding pacemaker.
For the simulations in this work we used the following set
of parameters: a1 = 40, a2 = a3 =50, u = 0.83, d = 3, e1 = 3.5, e2
= 5, and e3 = 12, f1 = 22 (70 bpm), f2 = 8.4 (50 bpm intrinsic
uncoupled rate), and f3 = 1.5 (30 bpm intrinsic uncoupled rate),
KSA = 0, KAV = KHP = 150 (for normal rhythm), k1 = 2×103, k2 =
4×102, k3 = 104, k4 = 2×103, c1 = c2 = 0.26, c3 = 0.12, c4 = 0.1,
Fig. 11. Same as in Fig. 7, but with signal started at 5.3 sec. Reversible
cardiac block.
b1 = b2 = b4 = 0, b3 = 0.015, d1 = d2 = 0.4, d3 = 0.09, d4 = 0.1,
h1 = h2 =0.004, h3 = h4 = 0.008, w11 = 0.13, w21 = w22 = 1.0,
w12 = 0.19, w13 = 0.12, w23 = 1.1, w14 = 0.22, w24 = 0.8. The
saturation elements have the following parameters: (+) x'1 :100
and 0, (-) x'1 : 0 and -100, (+) x'3 : 100 and 0, (-) x'3 : 0 and -100
for upper and lower limits, respectively. The coupling
coefficients Kmuscle in muscle blocks (Fig. 3) are KP = KTa =
4×10−5, KQRS = 9×10−5, and KT = 6×10−5.

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 Fig. 12. Simulated AF (top) and VF (bottom). Arrows indicate the moments of fibrillations initiation by EP (5th second) and termination by the applied AC
signal (15th second).
To apply external signals, in this work we use two different
schemes. First one is to demonstrate the response of the
cardiac model on the direct simultaneous external stimulation
of the natural pacemakers added to the first equation of (1)
similar to the approach used for ion channel cardiac models
[4]:
x'i = yi + I ext .
Here I ext = A ⋅ sin(ωt ) , A and ω are the amplitude and
frequency of the external AC signal, respectively. For this
purpose, the general scheme of the model was modified by
addition of sinusoidal pulsed generator, demonstrated in Fig.
4(a). We added second input (In2) for each pacemaker block in
a way as shown in Fig. 4(b), corresponding to (4). In the
absence of an external signal on the In2 input, the system
behaves exactly as the original one.
The second approach assumes application of an ectopic
pacemaker (EP) signal IEP to the cardiac muscles in (2)
demonstrating the ability of the model to simulate appearance
of atrial (AF) and ventricular (VF) fibrillations:
I j = 0.5 ⋅ ( I norm
j + I EP ) .
We added a block generating pulsed sinusoidal IEP (Fig. 5) to
the original scheme of Fig. 1. This EP subsystem was inserted
into the circuit in the place marked by open circles between x’
output of either SA block (for AF) or HP block (for VF) and
pertinent saturation elements. The parameters of the EP
subsystem elements are as follows: pulse generator: amplitude
-0.5, period 20, pulse width 10% (2 sec), pulse delay 5 sec;
sine with amplitude 40, phase 50, and frequencies 42 rad/sec
and 30 rad/sec for AF and VF, respectively. The block allows
the passage of unchanged signal from a pacemaker output to
the saturation elements when the signal by the pulse generator
is at zero level, and reduces the pacemaker’s output signal in
half before its addition with EP signal, when the signal is at
unity level.
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III. RESULTS
Figure 6 demonstrates calculated action potentials of SA,
AV, and HP normally coupled pacemakers (top), simulated
ECG (middle) at sinus rhythm of 70 bpm without application
of an AC signal, and normal ECG from MIT-BIH database
[12] for comparison.
(4) The results of application pulsed sinusoidal signal
simultaneously to all three natural pacemakers are shown in
Figs. 7-11. All applied AC signals had zero bias. With
application of the AC signal at 5.0 sec (A = 400, ω = 150
rad/sec, pulse width 1.5 sec) we observed amplitude death in
the pacemaker oscillators and asystole on ECG which is
irreversible even over a long enough period of time (Fig. 7).
When we reduced amplitude to 300 (Fig. 8), reduced pulse
width to 1.0 sec (Fig. 9), increased AC frequency to 180
rad/sec (Fig. 10), and changed the starting moment of AC
signal application to 5.3 sec (Fig. 11), we obtained recovery of
the pacemaker oscillations and ECG rhythm (reversible
conduction block) in approximately 3 sec, 3 sec, 1 sec, and 1.7
sec, respectively. Such behavior of the model system was
expected and predictable [1, 2, 13]. The dependence of the
response on the AC signal phase (Figs. 9 and 10) and
(5) pacemaker phase at the moment of AC application (Fig. 11)
can be attributed to the experimentally observed dependence of
defibrillation success on the cardiac cycle phase [13].
Since in this scheme the AC signals were intentionally
applied to the pacemakers only, and not to the muscles, the
applied signal itself is not seen on the ECGs.
Simulated ECG waveforms in the case of application of a
simplified (sine) EP signal to the AT and VN muscles are
shown in Fig. 12. Here we observed AF (top) and VF (bottom)
ECG waveforms in the interval between 5th and 15th seconds
during which the EP stimulation was applied. Although these
ECGs are very similar to real clinical fibrillation data [14], we
did not check here whether the AF and VF waveforms
demonstrate real chaotic behavior, as it was not a goal of this
work. Much better representation of the EP signal and the
results of its application to the cardiac oscillator model can be
found elsewhere [15], and it can be easily implemented in the
Simulink model under consideration.
As for limitations of the model, we would like to point out
that it does not reflect electrical processes associated with
three-dimensional heart structure, but still can represent some
of them in a simplified manner with further modifications.
Moreover, the proposed model can be very useful and
convenient for studying the influence of external stimulation
on global cardiac dynamics and synchronization behavior.
IV. CONCLUSION
We developed a simple and effective MATLAB/Simulink
heterogeneous oscillator heart model capable to simulate the
effect of external electrical signals on cardiac rhythm
dynamics.
Using the model we observed reversible and irreversible
conduction blocks as well as atrial and ventricular fibrillations
under application of an AC signals with different amplitude,
frequency and duration to the natural pacemakers and cardiac
muscles, respectively.
The proposed model can be also considered as an
intermediate step to its hardware electronic implementation for
educational and testing purposes.
ACKNOWLEDGMENT
The authors thank J. L. Aragón and M. A. Quiroz-Juárez
for valuable discussions and advices. The work was supported
by the University of Aizu Competitive Research Grant P-28-
28.
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