Multiparametric analysis of geometric features of fibrotic textures leading to cardiac arrhythmias

T Nezlobinsky,A V Panfilov,A Okenov

doi:10.1038/s41598-021-00606-x

T Nezlobinsky, A V Panfilov + Show 1 more

Open Access

https://doi.org/10.1038/s41598-021-00606-x

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Journal: Scientific Reports	Publication Date: Oct 26, 2021
Citations: 3	License type: open-access

Affiliation: Ghent University, Ural Federal University

Abstract

One of the important questions in cardiac electrophysiology is to characterise the arrhythmogenic substrate; for example, from the texture of the cardiac fibrosis, which is considered one of the major arrhythmogenic conditions. In this paper, we perform an extensive in silico study of the relationships between various local geometric characteristics of fibrosis on the onset of cardiac arrhythmias. In order to define which texture characteristics have better predictive value, we induce arrhythmias by external stimulation, selecting 4363 textures in which arrhythmia can be induced and also selecting 4363 non-arrhythmogenic textures. For each texture, we determine such characteristics as cluster area, solidity, mean distance, local density and zig-zag propagation path, and compare them in arrhythmogenic and non-arrhythmogenic cases. Our study shows that geometrical characteristics, such as cluster area or solidity, turn out to be the most important for prediction of the arrhythmogenic textures. Overall, we were able to achieve an accuracy of 67% for the arrhythmogenic texture-classification problem. However, the accuracy of predictions depends on the size of the region chosen for the analysis. The optimal size for the local areas of the tissue was of the order of 0.28 of the wavelength of the arrhythmia. We discuss further developments and possible applications of this method for characterising the substrate of arrhythmias in fibrotic textures.

Highlights

One of the important questions in cardiac electrophysiology is to characterise the arrhythmogenic substrate; for example, from the texture of the cardiac fibrosis, which is considered one of the major arrhythmogenic conditions
The authors showed that the highest probability of arrhythmias occurs when wave propagation is close to the percolation threshold, i.e., when wave propagation is almost blocked due to the presence of the fibrosis
We studied the process of arrhythmia generation by external highfrequency stimulation in fibrotic textures

Summary

Introduction

One of the important questions in cardiac electrophysiology is to characterise the arrhythmogenic substrate; for example, from the texture of the cardiac fibrosis, which is considered one of the major arrhythmogenic conditions. Our study shows that geometrical characteristics, such as cluster area or solidity, turn out to be the most important for prediction of the arrhythmogenic textures. One of the best-known arrhythmogenic conditions is fibrosis of cardiac tissue, i.e., the presence of a large number of inexcitable cells: fibroblasts or myofibroblasts[2] Such cells disturb normal wave propagation and lead to the formation of wavebreaks and cardiac arrhythmias. The authors showed that the highest probability of arrhythmias occurs when wave propagation is close to the percolation threshold, i.e., when wave propagation is almost blocked due to the presence of the fibrosis Their second finding was that the probability of arrhythmias was strongly correlated with the probability of the formation of fibrotic clusters above a typical size. Which of the above-listed features of fibrosis are the most important for the onset of arrhythmias, and whether it is possible to distinguish arrhythmogenic from non-arrhythmogenic textures based on these features, remain largely under investigation

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