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research article

A Computational Study of the Electrophysiological Substrate in Patients Suffering From Atrial Fibrillation

Pagani, S.
•
Dede', L.
•
Frontera, A.
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July 8, 2021
Frontiers In Physiology

In the context of cardiac electrophysiology, we propose a novel computational approach to highlight and explain the long-debated mechanisms behind atrial fibrillation (AF) and to reliably numerically predict its induction and sustainment. A key role is played, in this respect, by a new way of setting a parametrization of electrophysiological mathematical models based on conduction velocities; these latter are estimated from high-density mapping data, which provide a detailed characterization of patients' electrophysiological substrate during sinus rhythm. We integrate numerically approximated conduction velocities into a mathematical model consisting of a coupled system of partial and ordinary differential equations, formed by the monodomain equation and the Courtemanche-Ramirez-Nattel model. Our new model parametrization is then adopted to predict the formation and self-sustainment of localized reentries characterizing atrial fibrillation, by numerically simulating the onset of ectopic beats from the pulmonary veins. We investigate the paroxysmal and the persistent form of AF starting from electro-anatomical maps of two patients. The model's response to stimulation shows how substrate characteristics play a key role in inducing and sustaining these arrhythmias. Localized reentries are less frequent and less stable in case of paroxysmal AF, while they tend to anchor themselves in areas affected by severe slow conduction in case of persistent AF.

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Type
research article
DOI
10.3389/fphys.2021.673612
Web of Science ID

WOS:000675589200001

Author(s)
Pagani, S.
Dede', L.
Frontera, A.
Salvador, M.
Limite, L. R.
Manzoni, A.
Lipartiti, F.
Tsitsinakis, G.
Hadjis, A.
Della Bella, P.
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Date Issued

2021-07-08

Publisher

FRONTIERS MEDIA SA

Published in
Frontiers In Physiology
Volume

12

Article Number

673612

Subjects

Physiology

•

atrial fibrillation

•

numerical simulation

•

cardiac electrophysiology

•

mathematical models

•

arrhythmia

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conduction-velocity

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ionic mechanisms

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models

•

monodomain

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bidomain

•

ablation

•

insights

•

voltage

Editorial or Peer reviewed

REVIEWED

Written at

EPFL

EPFL units
CMCS  
Available on Infoscience
July 31, 2021
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/180301
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