Abstract 17049: Computer Simulation to Study the Effect of Structural Remodeling on Atrial Fibrillation Using Clinically-obtained Cardiac MRIs

• Published in: Circulation (New York, N.Y.) N.Y.), 2015-11, Vol.132 (Suppl_3 Suppl 3), p.A17049-A17049
• Main Authors: Ng, Jason, Ng, Justin K, Parikh, Paras, Goldberger, Jeffrey J, Markl, Michael, Carr, James, Bai, Wenjia, Kanagaratnam, Prapa, Lim, Phang B, Malcolme-Lawes, Louisa C, Qureshi, Norman A, Peters, Nicholas S
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.132.suppl_3.17049

IntroductionStructural remodeling of the atria in the form of fibrosis is known to be a contributing factor for the initiation and maintenance of atrial fibrillation (AF).HypothesisUsing computer simulation based on clinically-obtained MRIs, we tested the hypothesis that both dense and diffuse fibrosis play significant roles in the inducibility of AF and the effectiveness of pulmonary vein (PV) ablation.MethodsMagnetic resonance angiograms and delayed enhancement MRIs (DEMRIs) of the left atrium from 34 AF patients were used to construct the models for the computer simulations. Using the Fenton-Karma action potential model, three conditions were tested for AF inducibility1) no fibrosis, 2) diffuse fibrosis, and 3) diffuse and dense fibrosis. AF induction was attempted at each of the four PVs and episodes lasting >30 s were considered sustained. Wide area PV ablation was simulated on all sustained episodes.ResultsWith no fibrosis, sustained AF was achieved in 55.9±32.0% of induction attempts. This percentage was significantly increased to 92.6±15.7% and 93.4±12.8% with diffuse fibrosis and combined dense and diffuse fibrosis, respectively (p