Chloroquine effect on rotor termination under paroxysmal and chronic atrial fibrillation. 2D simulation study

Tobón, Catalina; Duarte, M.; Duque, J. E.; Becerra, Miguel A.; Arango, Sandra S.; Cardona, Karen; Sáiz, Javier

doi:10.1109/concapan.2014.7000401

Cited by 3 publications

(3 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As suggested, the synergetic antiarrhythmic treatment leads to more effective termination of atrial reentries (Aguilar et al, 2015; Ni et al, 2016), while ventricular side effects in the ventricles are limited. Furthermore, the relationship between drug concentration and AF termination is also considered in other studies (Duarte et al, 2013; Tobón et al, 2014a, 2017).…”

Section: Resultsmentioning

confidence: 99%

“…According to this study, increased ventricular proarrhythmia correlates with drug effectiveness close to 100%, while in case of minimum ventricular proarrhythmia, AF termination rates were low. Furthermore, several potassium channel blockers were also analyzed, in terms of computer models, in order to examine their effect on AF termination (Scholz et al, 2013; Tobón et al, 2014a; Aguilar et al, 2017; Ellinwood et al, 2017a). Ni et al (2017b) compared the effects on atrial and ventricular activation of these two types of blockers combination to single channel blockers usage.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Understanding the Beat-to-Beat Variations of P-Waves Morphologies in AF Patients During Sinus Rhythm: A Scoping Review of the Atrial Simulation Studies

et al. 2019

View full text Add to dashboard Cite

The remarkable advances in high-performance computing and the resulting increase of the computational power have the potential to leverage computational cardiology toward improving our understanding of the pathophysiological mechanisms of arrhythmias, such as Atrial Fibrillation (AF). In AF, a complex interaction between various triggers and the atrial substrate is considered to be the leading cause of AF initiation and perpetuation. In electrocardiography (ECG), P-wave is supposed to reflect atrial depolarization. It has been found that even during sinus rhythm (SR), multiple P-wave morphologies are present in AF patients with a history of AF, suggesting a higher dispersion of the conduction route in this population. In this scoping review, we focused on the mechanisms which modify the electrical substrate of the atria in AF patients, while investigating the existence of computational models that simulate the propagation of the electrical signal through different routes. The adopted review methodology is based on a structured analytical framework which includes the extraction of the keywords based on an initial limited bibliographic search, the extensive literature search and finally the identification of relevant articles based on the reference list of the studies. The leading mechanisms identified were classified according to their scale, spanning from mechanisms in the cell, tissue or organ level, and the produced outputs. The computational modeling approaches for each of the factors that influence the initiation and the perpetuation of AF are presented here to provide a clear overview of the existing literature. Several levels of categorization were adopted while the studies which aim to translate their findings to ECG phenotyping are highlighted. The results denote the availability of multiple models, which are appropriate under specific conditions. However, the consideration of complex scenarios taking into account multiple spatiotemporal scales, personalization of electrophysiological and anatomical models and the reproducibility in terms of ECG phenotyping has only partially been tackled so far.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Understanding the Beat-to-Beat Variations of P-Waves Morphologies in AF Patients During Sinus Rhythm: A Scoping Review of the Atrial Simulation Studies

et al. 2019

View full text Add to dashboard Cite

show abstract

“…The experimental data of ionic channel conductance changes related to PAF have been incorporated in the CRN model of human atrial action potential (AP). Based on [14] the conductance of IK1 was increased by 100% in order to reproduce atrial remodelling under PAF conditions. The extent of the atrial region where electrical remodelling is present is also a factor that may affect the analysis.…”

Section: Methodsmentioning

confidence: 99%

Multiple P-Wave Morphologies in Paroxysmal Atrial Fibrillation Patients During Sinus Rhythm: A Simulation Study

Filos

Maglaveras

Chouvarda

et al. 2018

2018 Computing in Cardiology Conference (CinC)

View full text Add to dashboard Cite

P-wave in electrocardiographic (ECG) signals represents the activation of the atrial substrate. Its shape is influenced by the origin of the sinus rhythm (SR) and the conduction of each part of the atria and thus the analysis of its morphology (PWM) can reveal information related to the atrial conduction routes. Recently, the analysis of the PWM from PAF patients during SR, revealed the presence of a distinct secondary morphology in a remarkable percentage of beats. We hypothesize that the variability on the PWM can be attributed to the coexistence of electrical remodeling and the transient modification of the conduction route which is the result of the shift of the stimulation site within the sinus node. In this study, the Courtemanche et al. model was incorporated in a 2D tissue of the left and the right atrium, while tissue heterogeneities were considered. Simulations were conducted, using the CHASTE platform, in normal and electrical remodeled tissue. In each simulation, the stimulation site was shifted within the sinus node. The results show that in electrical remodeled tissue, the shift of the stimulation site led to significant changes in the activation time in the atria compared with the healthy tissue. In future, the use of a 3D model of human atria is necessary in order to investigate the reproducibility of the results while the conditions under which the pacemaker location shifts must be also revealed.

show abstract

Atrial arrhythmogenicity of KCNJ2 mutations in short QT syndrome: Insights from virtual human atria

Whittaker

Harchi

et al. 2017

PLoS Comput Biol

View full text Add to dashboard Cite

Gain-of-function mutations in KCNJ2-encoded Kir2.1 channels underlie variant 3 (SQT3) of the short QT syndrome, which is associated with atrial fibrillation (AF). Using biophysically-detailed human atria computer models, this study investigated the mechanistic link between SQT3 mutations and atrial arrhythmogenesis, and potential ion channel targets for treatment of SQT3. A contemporary model of the human atrial action potential (AP) was modified to recapitulate functional changes in IK1 due to heterozygous and homozygous forms of the D172N and E299V Kir2.1 mutations. Wild-type (WT) and mutant formulations were incorporated into multi-scale homogeneous and heterogeneous tissue models. Effects of mutations on AP duration (APD), conduction velocity (CV), effective refractory period (ERP), tissue excitation threshold and their rate-dependence, as well as the wavelength of re-entry (WL) were quantified. The D172N and E299V Kir2.1 mutations produced distinct effects on IK1 and APD shortening. Both mutations decreased WL for re-entry through a reduction in ERP and CV. Stability of re-entrant excitation waves in 2D and 3D tissue models was mediated by changes to tissue excitability and dispersion of APD in mutation conditions. Combined block of IK1 and IKr was effective in terminating re-entry associated with heterozygous D172N conditions, whereas IKr block alone may be a safer alternative for the E299V mutation. Combined inhibition of IKr and IKur produced a synergistic anti-arrhythmic effect in both forms of SQT3. In conclusion, this study provides mechanistic insights into atrial proarrhythmia with SQT3 Kir2.1 mutations and highlights possible pharmacological strategies for management of SQT3-linked AF.

show abstract

Chloroquine effect on rotor termination under paroxysmal and chronic atrial fibrillation. 2D simulation study

Cited by 3 publications

References 16 publications

Understanding the Beat-to-Beat Variations of P-Waves Morphologies in AF Patients During Sinus Rhythm: A Scoping Review of the Atrial Simulation Studies

Understanding the Beat-to-Beat Variations of P-Waves Morphologies in AF Patients During Sinus Rhythm: A Scoping Review of the Atrial Simulation Studies

Multiple P-Wave Morphologies in Paroxysmal Atrial Fibrillation Patients During Sinus Rhythm: A Simulation Study

Atrial arrhythmogenicity of KCNJ2 mutations in short QT syndrome: Insights from virtual human atria

Contact Info

Product

Resources

About