Paper Info
Title
The Combination Of Pulmonary Vein Electrophysiology And Atrial Fibrosis Determines Driver Location
Abstract
Patients exhibit a range of pulmonary vein (PV) and fibrosis properties, but their individual and combined effects on arrhythmia inducibility and maintenance mechanisms is unknown. We aim to predict locations of high phase singularity (PS) density using a combination of PV electrophysiology and fibrosis measurements. We used a bilayer computational human atrial model with interstitial fibrosis based on delayed-enhancement MRI (DE-MRI), including high or low levels of fibrosis. PV action potential duration and conduction velocity were varied. Reentry was observed around the left atrial (LA)-PV junction in a subset of patients and reproduced in the model for PV properties with baseline APD, but not for short. For patients for whom rotors were located away from the PVs, increasing model fibrosis from low to high increased the model agreement with clinical PS density 2.3 +/- 1.0 fold. For other patients, lower levels of fibrosis with baseline PV properties were more appropriate. These results suggest that modelling both PV electrophysiology and atrial fibrosis is important for determining arrhythmia mechanisms. The combined use of PV and DE-MRI measurements may improve ablation therapy success.
Year
DOI
Venue
2017
10.22489/CinC.2017.374-228
2017 COMPUTING IN CARDIOLOGY (CINC)
Field
DocType
Volume
Fibrosis,Nerve conduction velocity,Internal medicine,Left atrial,Action potential duration,Cardiology,Ablation Therapy,Reentry,Medicine,Electrophysiology,Pulmonary vein
Conference
44
ISSN
Citations 
PageRank 
2325-8861
1
0.38
References 
Authors
0
7
Name
Order
Citations
PageRank
c h roney1124.61
Jason D. Bayer2104.31
Rémi Dubois314623.45
Marianna Meo4257.18
Hubert Cochet5116.19
Pierre Jaïs621.09
E J Vigmond79213.14