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Modelling methodology of atrial fibrosis affects rotor dynamics and electrograms
- Source :
- EP-Europace, EP-Europace, 2016, 18 (suppl_4), pp.iv146-iv155. ⟨10.1093/europace/euw365⟩, EP-Europace, Oxford University Press (OUP): Policy B, 2016, 18 (suppl_4), pp.iv146-iv155. ⟨10.1093/europace/euw365⟩
- Publication Year :
- 2016
- Publisher :
- Oxford University Press (OUP): Policy B, 2016.
-
Abstract
- Aims Catheter ablation is an effective technique for terminating atrial arrhythmia. However, given a high atrial fibrillation (AF) recurrence rate, optimal ablation strategies have yet to be defined. Computer modelling can be a powerful aid but modelling of fibrosis, a major factor associated with AF, is an open question. Several groups have proposed methodologies based on imaging data, but no comparison to determine which methodology best corroborates clinically observed reentrant behaviour has been performed. We examined several methodologies to determine the best method for capturing fibrillation dynamics. Methods and results Patient late gadolinium-enhanced magnetic resonance imaging data were transferred onto a bilayer atrial computer model and used to assign fibrosis distributions. Fibrosis was modelled as conduction disturbances (lower conductivity, edge splitting, or percolation), transforming growth factor-β1 ionic channel effects, myocyte-fibroblast coupling, and combinations of the preceding. Reentry was induced through pulmonary vein ectopy and the ensuing rotor dynamics characterized. Non-invasive electrocardiographic imaging data of the patients in AF was used for comparison. Electrograms were computed and the fractionation durations measured over the surface. Edge splitting produced more phase singularities from wavebreaks than the other representations. The number of phase singularities seen with percolation was closer to the clinical values. Addition of fibroblast coupling had an organizing effect on rotor dynamics. Simple tissue conductivity changes with ionic changes localized rotors over fibrosis which was not observed with clinical data. Conclusion The specific representation of fibrosis has a large effect on rotor dynamics and needs to be carefully considered for patient specific modelling.
- Subjects :
- 0301 basic medicine
Patient-Specific Modeling
Pathology
medicine.medical_treatment
Action Potentials
030204 cardiovascular system & hematology
Electrocardiography
0302 clinical medicine
Fibrosis
Heart Rate
Atrial Fibrillation
medicine.diagnostic_test
Models, Cardiovascular
Atrial fibrillation
Signal Processing, Computer-Assisted
Reentry
Mechanics
Supplement: Reviews
Ablation
Atrial Function
Prognosis
Magnetic Resonance Imaging
Reentrancy
cardiovascular system
[SDV.IB]Life Sciences [q-bio]/Bioengineering
medicine.symptom
Cardiology and Cardiovascular Medicine
Electrophysiologic Techniques, Cardiac
medicine.medical_specialty
Catheter ablation
macromolecular substances
03 medical and health sciences
[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
Non-invasive electrocardiographic imaging
Predictive Value of Tests
Physiology (medical)
medicine
Humans
Heart Atria
Fibrillation
Electrogram fractionation
business.industry
Phase singularity mapping
Magnetic resonance imaging
Atrial fibrosis
medicine.disease
030104 developmental biology
Computer modelling
business
Subjects
Details
- Language :
- English
- ISSN :
- 10995129 and 15322092
- Database :
- OpenAIRE
- Journal :
- EP-Europace, EP-Europace, 2016, 18 (suppl_4), pp.iv146-iv155. ⟨10.1093/europace/euw365⟩, EP-Europace, Oxford University Press (OUP): Policy B, 2016, 18 (suppl_4), pp.iv146-iv155. ⟨10.1093/europace/euw365⟩
- Accession number :
- edsair.doi.dedup.....cab927f6173ca6d987476a9557c0e9cf