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research article

Influence of atrial substrate on local capture induced by rapid pacing of atrial fibrillation

Rusu, Alexandru  
•
Jacquemet, Vincent
•
Vesin, Jean-Marc  
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2014
Europace

Preliminary studies showed that the septum area was the only location allowing local capture of both the atria during rapid pacing of atrial fibrillation (AF) from a single site. The present model-based study investigated the influence of atrial substrate on the ability to capture AF when pacing the septum. Three biophysical models of AF with an identical anatomy from human atria but with different AF substrates were used: (i) AF based on multiple wavelets, (ii) AF based on heterogeneities in vagal activation, (iii) AF based on heterogeneities in repolarization. A fourth anatomical model without Bachmann's bundle (BB) was also implemented. Rapid pacing was applied from the septum at pacing cycle lengths in the range of 50-100% of AF cycle length. Local capture was automatically assessed with 24 pairs of electrodes evenly distributed on the atrial surface. The results were averaged over 16 AF simulations. In the homogeneous substrate, AF capture could reach 80% of the atrial surface. Heterogeneities degraded the ability to capture during AF. In the vagal substrate, the capture tended to be more regular and the degradation of the capture was not directly related to the spatial extent of the heterogeneities. In the third substrate, heterogeneities induced wave anchorings and wavebreaks even in areas close to the pacing site, with a more dramatic effect on AF capture. Finally, BB did not significantly affect the ability to capture. Atrial fibrillation substrate had a significant effect on rapid pacing outcomes. The response to therapeutic pacing may therefore be specific to each patient.

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Type
research article
DOI
10.1093/europace/euu003
Web of Science ID

WOS:000336080400027

Author(s)
Rusu, Alexandru  
Jacquemet, Vincent
Vesin, Jean-Marc  
Virag, Nathalie
Date Issued

2014

Publisher

Oxford University Press

Published in
Europace
Volume

16

Issue

5

Start page

766

End page

773

Subjects

Atrial fibrillation

•

Septal pacing

•

Computer modelling

•

Pacemakers

Editorial or Peer reviewed

REVIEWED

Written at

EPFL

EPFL units
SCI-STI-JMV  
Available on Infoscience
June 23, 2014
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/104604
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