Pro-Arrhythmogenic Effects of Heterogeneous Tissue Curvature　― A Suggestion for Role of Left Atrial Appendage in Atrial Fibrillation

• Published in: Circulation Journal 2018/12/25, Vol.83(1), pp.32-40
• Main Authors: Song, Jun-Seop, Kim, Jaehyeok, Lim, Byounghyun, Lee, Young-Seon, Hwang, Minki, Joung, Boyoung, Shim, Eun Bo, Pak, Hui-Nam
• Format: Article
• Language: English
• Subjects: Arrhythmias, Cardiac - diagnostic imaging; Arrhythmias, Cardiac - pathology; Arrhythmias, Cardiac - physiopathology; Atrial Appendage - diagnostic imaging; Atrial Appendage - pathology; Atrial Appendage - physiopathology; Atrial fibrillation; Atrial Fibrillation - diagnostic imaging; Atrial Fibrillation - pathology; Atrial Fibrillation - physiopathology; Curvature; Humans; Left atrial appendage; Male; Modeling; Models, Cardiovascular; Tomography, X-Ray Computed
• ISSN: 1346-9843; 1347-4820; 1347-4820
• DOI: 10.1253/circj.CJ-18-0615

Background: The arrhythmogenic role of complex atrial morphology has not yet been clearly elucidated. We hypothesized that bumpy tissue geometry can induce action potential duration (APD) dispersion and wavebreak in atrial fibrillation (AF). Methods and Results: We simulated a 2D-bumpy atrial model by varying the degree of bumpiness, and 3D-left atrial (LA) models integrated by LA computed tomographic (CT) images taken from 14 patients with persistent AF. We also analyzed wave-dynamic parameters with bipolar electrograms during AF and compared them with LA-CT geometry in 30 patients with persistent AF. In the 2D-bumpy model, APD dispersion increased (P