Modeling of Atrial Fibrillation

Abstract

Computer modeling of atrial fibrillation (AF) is considered today as a potentially effective tool for better understanding AF mechanisms and for the development of therapeutic options. Computer models are based on an integrative approach, from the molecule to the patient, incorporating data about cell electrophysiology, cell-to-cell coupling and atrial anatomy. The link to clinical experiments is provided by the computation of endocardial electrograms or surface electrocardiograms (ECG). In this chapter we describe how modeling can be used to study different forms of AF and to evaluate therapies such as antiarrhythmic drugs, ablation and antitachycardia pacing. The ultimate goal is the development of patient-specific models in order to test AF therapies in the model before applying it to the patient.

Three‐dimensional Integrated Functional, Structural, and Computational Mapping to Define the Structural “Fingerprints” of Heart‐Specific Atrial Fibrillation Drivers in Human Heart Ex Vivo

“…The computer modeling approach is currently the only way to compare a variety of ablation strategies on the same heart and can be used for ablation planning and guidance . Earlier computer modeling studies were utilized to test the effectiveness of different PV isolation ablation patterns and to evaluate ablation lesion gaps . A recent study identified optimal ablation targets with smallest amount of tissue ablated to terminate left atrial flutter using patient‐specific models based on in vivo late gadolinium–enhanced MRI …”

Modeling left and right atrial contributions to the ECG: A dipole-current source approach

“…Activation time was 132 ms. The activation pattern has been previously compared to clinical data and other computer models [10,2]. After left-right conduction delay was introduced (Fig.…”

“…1A). The geometry was derived from an imaging dataset of a patient with AF [10] and included the atria, atrial and ventricular blood cavities, the lungs and the torso. The atrial model (Fig.…”

Optimization of Catheter Ablation of Atrial Fibrillation: Insights Gained from Clinically-Derived Computer Models

“…Generic computer models of atrial electrical activation provide a powerful framework for understanding the structure-function basis of reentrant atrial arrhythmias. This view has motivated numerous recent models of atrial electrical function [ 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 ], especially since Harrild and Henriquez published the first 3D electrical conduction in a realistic human bi-atrial geometry in 2000 [ 21 ]. Harrild and Henriquez’s computer model incorporates both the left and right atrial chambers and major muscle bundles, including the crista terminalis (CT), pectinate muscles (PMs) and Bachmann’s bundle (BB).…”

“…However, whether to isolate individual PV exclusively or together, with or without additional ablation strategies, such as the linear ablation approach, is still an ongoing debate [ 7 ]. Kappenberger et al have developed and studied different ablation patterns systematically using a simplified atrial geometric model of chronic AF in the past decade [ 20 , 35 , 36 , 37 , 39 , 40 ]. In their studies, a monolayer model instead of a structurally-detailed model was constructed based on the endocardial contour of the clinical MRI of human atria to alleviate the computational load.…”