Virtual electrophysiological study of atrial fibrillation in fibrotic remodeling. McDowell, K., Zahid, S., Vadakkumpadan, F., Blauer, J., MacLeod, R., & Trayanova, N. PLoS One, 10(2):e0117110, 2015. bibtex @Article{RSM:McD2015,
author = "K.S. McDowell and S. Zahid and F. Vadakkumpadan and J.
Blauer and R.S. MacLeod and N.A. Trayanova",
title = "Virtual electrophysiological study of atrial fibrillation
in fibrotic remodeling.",
journal = "PLoS One",
year = "2015",
volume = "10",
number = "2",
pages = "e0117110",
robnote = "We aimed to
provide a proof-of-concept that patient-specific virtual
electrophysiological study that combines i) atrial
structure and fibrosis distribution from clinical MRI and
ii) modeling of atrial electrophysiology, could be used to
predict: (1) how fibrosis distribution determines the
locations from which paced beats degrade into AF; (2) the
dynamic behavior of persistent AF rotors; and (3) the
optimal ablation targets in each patient. Four MRI-based
patient-specific models of fibrotic left atria were
generated, ranging in fibrosis amount. Virtual
electrophysiological studies were performed in these
models, and where AF was inducible, the dynamics of AF
were used to determine the ablation locations that render
AF non-inducible. In 2 of the 4 models patient-specific
models AF was induced; in these models the distance
between a given pacing location and the closest fibrotic
region determined whether AF was inducible from that
particular location, with only the mid-range distances
resulting in arrhythmia. Phase singularities of persistent
rotors were found to move within restricted regions of
tissue, which were independent of the pacing location from
which AF was induced. Electrophysiological sensitivity
analysis demonstrated that these regions changed little
with variations in electrophysiological parameters.
Patient-specific distribution of fibrosis was thus found
to be a critical component of AF initiation and
maintenance. When the restricted regions encompassing the
meander of the persistent phase singularities were modeled
as ablation lesions, AF could no longer be induced. The
study demonstrates that a patient-specific modeling
approach to identify non-invasively AF ablation targets
prior to the clinical procedure is feasible.",
bibdate = "Fri Jun 19 06:43:08 2015",
pmcid = "PMC4333565",
}
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Four MRI-based patient-specific models of fibrotic left atria were generated, ranging in fibrosis amount. Virtual electrophysiological studies were performed in these models, and where AF was inducible, the dynamics of AF were used to determine the ablation locations that render AF non-inducible. In 2 of the 4 models patient-specific models AF was induced; in these models the distance between a given pacing location and the closest fibrotic region determined whether AF was inducible from that particular location, with only the mid-range distances resulting in arrhythmia. Phase singularities of persistent rotors were found to move within restricted regions of tissue, which were independent of the pacing location from which AF was induced. Electrophysiological sensitivity analysis demonstrated that these regions changed little with variations in electrophysiological parameters. Patient-specific distribution of fibrosis was thus found to be a critical component of AF initiation and maintenance. When the restricted regions encompassing the meander of the persistent phase singularities were modeled as ablation lesions, AF could no longer be induced. The study demonstrates that a patient-specific modeling approach to identify non-invasively AF ablation targets prior to the clinical procedure is feasible.","bibdate":"Fri Jun 19 06:43:08 2015","pmcid":"PMC4333565","bibtex":"@Article{RSM:McD2015,\n author = \"K.S. McDowell and S. Zahid and F. Vadakkumpadan and J.\n Blauer and R.S. MacLeod and N.A. Trayanova\",\n title = \"Virtual electrophysiological study of atrial fibrillation\n in fibrotic remodeling.\",\n journal = \"PLoS One\",\n year = \"2015\",\n volume = \"10\",\n number = \"2\",\n pages = \"e0117110\",\n robnote = \"We aimed to\n provide a proof-of-concept that patient-specific virtual\n electrophysiological study that combines i) atrial\n structure and fibrosis distribution from clinical MRI and\n ii) modeling of atrial electrophysiology, could be used to\n predict: (1) how fibrosis distribution determines the\n locations from which paced beats degrade into AF; (2) the\n dynamic behavior of persistent AF rotors; and (3) the\n optimal ablation targets in each patient. Four MRI-based\n patient-specific models of fibrotic left atria were\n generated, ranging in fibrosis amount. Virtual\n electrophysiological studies were performed in these\n models, and where AF was inducible, the dynamics of AF\n were used to determine the ablation locations that render\n AF non-inducible. In 2 of the 4 models patient-specific\n models AF was induced; in these models the distance\n between a given pacing location and the closest fibrotic\n region determined whether AF was inducible from that\n particular location, with only the mid-range distances\n resulting in arrhythmia. Phase singularities of persistent\n rotors were found to move within restricted regions of\n tissue, which were independent of the pacing location from\n which AF was induced. Electrophysiological sensitivity\n analysis demonstrated that these regions changed little\n with variations in electrophysiological parameters.\n Patient-specific distribution of fibrosis was thus found\n to be a critical component of AF initiation and\n maintenance. When the restricted regions encompassing the\n meander of the persistent phase singularities were modeled\n as ablation lesions, AF could no longer be induced. The\n study demonstrates that a patient-specific modeling\n approach to identify non-invasively AF ablation targets\n prior to the clinical procedure is feasible.\",\n bibdate = \"Fri Jun 19 06:43:08 2015\",\n pmcid = \"PMC4333565\",\n}\n\n","author_short":["McDowell, K.","Zahid, S.","Vadakkumpadan, F.","Blauer, J.","MacLeod, R.","Trayanova, N."],"key":"RSM:McD2015","id":"RSM:McD2015","bibbaseid":"mcdowell-zahid-vadakkumpadan-blauer-macleod-trayanova-virtualelectrophysiologicalstudyofatrialfibrillationinfibroticremodeling-2015","role":"author","urls":{},"metadata":{"authorlinks":{}},"downloads":0,"html":""},"search_terms":["virtual","electrophysiological","study","atrial","fibrillation","fibrotic","remodeling","mcdowell","zahid","vadakkumpadan","blauer","macleod","trayanova"],"keywords":[],"authorIDs":[],"dataSources":["5HG3Kp8zRwDd7FotB","5G2skx26SJtreWr4m"]}