Abstract
Atrial fibrillation (AF) is the most common type of arrhythmia, which undermines cardiac function. Atrial fibrillation is a multi-facet malady and it may occur as a result of other diseases or it may trigger other problems. One of the main complications of AF is stroke due to the possibility of clot formation inside the atrium. However, the possibility of stroke occurrence due to the AF and the location from which an embolus dispatches are subject of debate. Another hypothesis about the embolus formation during AF is thrombus formation in aorta and carotid arteries, embolus detachment and its movement. To investigate the possibility of the latter postulation, the current work suggests a parametric study to quantify the sensitivity of aortic flow to four common AF traits including lack of atrial kick, atrial remodelling, left ventricle systolic dysfunction, and high frequency fibrillation. The simulation was carried out by coupling several in-house codes and ANSYS-CFX module. The results reveal that AF traits lower flow rate at left ventricular outflow tract, which in general lowers blood perfusion to systemic, cerebral and coronary circulations. Consequently, it leads to endothelial cell activation potential (ECAP) increase and variation of flow structure that both suggest predisposed areas to atherogenesis and thrombus formation in different regions in ascending aorta, aortic arch and descending thoracic aorta.
Highlights
Atrial fibrillation (AF) is the most common arrhythmia
For the ELA values higher than ELA3, left atrium (LA) loses its active contraction, and so the flow across the left ventricular outflow tract (LVOT) diminishes, which is accompanied by higher endothelial cell activation potential (ECAP)
Patterns of TAWSS gradient (TAWSSG) within the considered range do not change significantly, the variations become more visible for the larger vessels including aortic artery, left common carotid artery (LCCA), right common carotid artery (RCCA), left subclavian artery (LSCA) and right subclavian artery (RSCA), while for the left coronary artery (LCA) and right coronary artery (RCA) this variation is less significant
Summary
Atrial fibrillation (AF) is the most common arrhythmia. It can exist in paroxysmal, persistent and long-standing persistent forms.[28] AF normally occurs in adults, and the likelihood of occurrence roughly increases with increasing age.[57]. In the UK alone around 1,180,000 AF cases were recorded between 2015 and 2016. The statistical data for the same region for the period 2004 to 2016 shows that the incidence of AF tends to increase as the population becomes older.[8] While AF has been considered as an independent risk factor, it occurs concomitantly with other diseases like hypertension and heart failure or can autonomously cause other types of cardiovascular diseases (CVDs) such as heart failure[6] and stroke.[34] Besides healthcare related issues, patients suffering from AF incur significant treatment costs,[45] since the disease necessitates the long-term clinical treatment and follow-up
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