Abstract
BackgroundWe previously reported that stable rotors were observed in in-silico human atrial fibrillation (AF) models, and were well represented by dominant frequency (DF). We explored the spatiotemporal stability of DF sites in 3D-AF models imported from patient CT images of the left atrium (LA).MethodsWe integrated 3-D CT images of the LA obtained from ten patients with persistent AF (male 80%, 61.8 ± 13.5 years old) into an in-silico AF model. After induction, we obtained 6 seconds of AF simulation data for DF analyses in 30 second intervals (T1–T9). The LA was divided into ten sections. Spatiotemporal changes and variations in the temporal consistency of DF were evaluated at each section of the LA. The high DF area was defined as the area with the highest 10% DF.Results1. There was no spatial consistency in the high DF distribution at each LA section during T1–T9 except in one patient (p = 0.027). 2. Coefficients of variation for the high DF area were highly different among the ten LA sections (p < 0.001), and they were significantly higher in the four pulmonary vein (PV) areas, the LA appendage, and the peri-mitral area than in the other LA sections (p < 0.001). 3. When we conducted virtual ablation of 10%, 15%, and 20% of the highest DF areas (n = 270 cases), AF was changed to atrial tachycardia (AT) or terminated at a rate of 40%, 57%, and 76%, respectively.ConclusionsSpatiotemporal consistency of the DF area was observed in 10% of AF patients, and high DF areas were temporally variable. Virtual ablation of DF is moderately effective in AF termination and AF changing into AT.
Highlights
Atrial fibrillation (AF) is the most common cardiac electrophysiological rhythm disturbance that results in the absence of normal atrial contractions
Coefficients of variation for the high dominant frequency (DF) area were highly different among the ten left atrium (LA) sections (p < 0.001), and they were significantly higher in the four pulmonary vein (PV) areas, the LA appendage, and the peri-mitral area than in the other LA sections (p < 0.001)
When we conducted virtual ablation of 10%, 15%, and 20% of the highest DF areas (n = 270 cases), atrial fibrillation (AF) was changed to atrial tachycardia (AT) or terminated at a rate of 40%, 57%, and 76%, respectively
Summary
Atrial fibrillation (AF) is the most common cardiac electrophysiological rhythm disturbance that results in the absence of normal atrial contractions. Narayan et al reported that detection and ablation of rotors in AF patients is effective in terminating AF and improves the clinical outcome of AF catheter ablation [3]. We explored the spatiotemporal stability of DF sites in patient-specific left atrium (LA) geometry-integrated in-silico modeling of human AF. The purpose of this study was to evaluate the spatiotemporal variability of high DF sites at nine specified periods in ten different LA sections among ten different patient-specific LA models of AF, as well as to assess the outcome of virtual ablation for high DF sites. We previously reported that stable rotors were observed in in-silico human atrial fibrillation (AF) models, and were well represented by dominant frequency (DF). We explored the spatiotemporal stability of DF sites in 3D-AF models imported from patient CT images of the left atrium (LA)
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
