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  4. Study of the impact of electrical heterogeneities in the right and left atrium on atrial fibrillation perpetuation
 
conference paper

Study of the impact of electrical heterogeneities in the right and left atrium on atrial fibrillation perpetuation

Luca, Adrian  
•
Jacquemet, Vincent
•
Virag, Nathalie
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2016
European Heart Journal
Congress of the European Society of Cardiology (ESC)

Introduction: Electrical heterogeneity in the atria has been consistently linked with the initiation and perpetuation of atrial fibrillation (AF). The present model-based study investigated the contribution of action potential duration (APD) heterogeneities in the left atrium (LA) and right atrium (RA) on the perpetuation of the reentrant activity during AF. Methods: A computer model with a geometry based on computed tomography of AF patients and a Courtemanche atrial cellular model was implemented. Self-terminated AF episodes were initiated via ramp pacing in a model with modified channel conductance, homogeneous tissue and 4:1 anisotropy ratio. Once AF was observed, random patchy heterogeneities with shorter APD were separately introduced in the LA and the RA. Percentage of heterogeneities was progressively increased from 20% to 80% of each atrium size (characteristic length scale of patches was 7.5mm). For each simulation, the following values were assessed: average AF duration, the number of sustained AF episodes (lasting more than 50s), number of wave-fronts (#WF) and AF cycle length (AFCL). The results were averaged across the atria surface over 130 simulations (26 AF initial conditions and 5 random localizations of heterogeneities). Results: For the model with no heterogeneities, #WF was 6.82±3.67, AFCL 278±52ms and the average AF duration 15.42±9s. For low percentage of heterogeneities there were no significant differences between RA, LA and the model with no heterogeneities. For high percentage of heterogeneities the results showed that a significant right-to-left atrial APD gradient was associated with more sustained AF episodes, longer duration, higher #WF and shorter AFCL compared to the left-to-right APD gradient (sustained AF episodes: 95% vs. 52%, p<10-4; duration: 48±9s vs. 32.8±21s, p<0.05; #WF: 11.72±3.3 vs. 9.7±3.1, p<10-4; AFCL: 209±69ms vs. 223±64ms, p<0.05). Conclusion: High inter-atria differences in APD significantly affect the dynamics and the duration of the reentrant activity. Our findings are in line with previous studies reporting the right atrium as the dominant driver in some persistent AF cases.

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Type
conference paper
Web of Science ID

WOS:000383869503030

Author(s)
Luca, Adrian  
Jacquemet, Vincent
Virag, Nathalie
Vesin, Jean-Marc  
Date Issued

2016

Publisher

Oxford Univ Press

Publisher place

Oxford

Published in
European Heart Journal
Total of pages

1

Volume

37

Start page

609

End page

609

Subjects

atrial fibrillation

•

biophysical model of the human atria

•

Electrical remodelling

Editorial or Peer reviewed

REVIEWED

Written at

EPFL

EPFL units
SCI-STI-JMV  
Event nameEvent placeEvent date
Congress of the European Society of Cardiology (ESC)

Rome, Italy

August 27-31, 2016

Available on Infoscience
January 24, 2017
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/133830
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