Patient-specific modeling of atrial fibrosis increases the accuracy of sinus rhythm simulations and may explain maintenance of atrial fibrillation

J Electrocardiol. 2014 May-Jun;47(3):324-8. doi: 10.1016/j.jelectrocard.2013.11.003. Epub 2013 Nov 21.

Abstract

Left atrial fibrosis is thought to contribute to the manifestation of atrial fibrillation (AF). Late Gadolinium enhancement (LGE) MRI has the potential to image regions of low perfusion, which can be related to fibrosis. We show that a simulation with a patient-specific model including left atrial regional fibrosis derived from LGE-MRI reproduces local activation in the left atrium more precisely than the regular simulation without fibrosis. AF simulations showed a spontaneous termination of the arrhythmia in the absence of fibrosis and a stable rotor center in the presence of fibrosis. The methodology may provide a tool for a deeper understanding of the mechanisms maintaining AF and eventually also for the planning of substrate-guided ablation procedures in the future.

Keywords: Atrial fibrillation; Atrial fibrosis; Computational modeling; Late enhance MRI.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Atrial Fibrillation / diagnosis
  • Atrial Fibrillation / physiopathology*
  • Electrocardiography / methods
  • Fibrosis / pathology
  • Fibrosis / physiopathology
  • Heart Atria / pathology*
  • Heart Atria / physiopathology*
  • Heart Conduction System / physiopathology*
  • Heart Rate*
  • Humans
  • Models, Cardiovascular*
  • Patient-Specific Modeling*
  • Reproducibility of Results
  • Sensitivity and Specificity