Studies of Therapeutic Strategies for Atrial Fibrillation Based on a Biophysical Model of the Human Atria

Uldry, Laurent; Virag, Nathalie; Vesin, Jean‐Marc; Kappenberger, Lukas

doi:10.1007/978-1-4419-6691-9_4

Cited by 2 publications

(2 citation statements)

References 37 publications

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“…The first clinically-derived computer models were developed for testing a variety of PV isolation ablation strategies [ 35 , 36 , 37 , 38 , 39 , 40 , 41 ]. PV isolation is considered to be the cornerstone of RFCA for patients with PAF and is widely used as the key component of ablation lesion sets for PeAF [ 42 ].…”

Section: Modeling Pulmonary Vein (Pv) Isolations Using Clinically-mentioning

confidence: 99%

“…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.…”

Section: Modeling Pulmonary Vein (Pv) Isolations Using Clinically-mentioning

confidence: 99%

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

Zhao

Kharche

et al. 2015

IJMS

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Atrial fibrillation (AF) is the most common heart rhythm disturbance, and its treatment is an increasing economic burden on the health care system. Despite recent intense clinical, experimental and basic research activity, the treatment of AF with current antiarrhythmic drugs and catheter/surgical therapies remains limited. Radiofrequency catheter ablation (RFCA) is widely used to treat patients with AF. Current clinical ablation strategies are largely based on atrial anatomy and/or substrate detected using different approaches, and they vary from one clinical center to another. The nature of clinical ablation leads to ambiguity regarding the optimal patient personalization of the therapy partly due to the fact that each empirical configuration of ablation lines made in a patient is irreversible during one ablation procedure. To investigate optimized ablation lesion line sets, in silico experimentation is an ideal solution. 3D computer models give us a unique advantage to plan and assess the effectiveness of different ablation strategies before and during RFCA. Reliability of in silico assessment is ensured by inclusion of accurate 3D atrial geometry, realistic fiber orientation, accurate fibrosis distribution and cellular kinetics; however, most of this detailed information in the current computer models is extrapolated from animal models and not from the human heart. The predictive power of computer models will increase as they are validated with human experimental and clinical data. To make the most from a computer model, one needs to develop 3D computer models based on the same functionally and structurally mapped intact human atria with high spatial resolution. The purpose of this review paper is to summarize recent developments in clinically-derived computer models and the clinical insights they provide for catheter ablation.

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Section: Modeling Pulmonary Vein (Pv) Isolations Using Clinically-mentioning

confidence: 99%

Section: Modeling Pulmonary Vein (Pv) Isolations Using Clinically-mentioning

confidence: 99%

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

Zhao

Kharche

et al. 2015

IJMS

View full text Add to dashboard Cite

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Computational modeling of the human atrial anatomy and electrophysiology

Dössel

Krueger

Weber

et al. 2012

Med Biol Eng Comput

127

122

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This review article gives a comprehensive survey of the progress made in computational modeling of the human atria during the last 10 years. Modeling the anatomy has emerged from simple "peanut"-like structures to very detailed models including atrial wall and fiber direction. Electrophysiological models started with just two cellular models in 1998. Today, five models exist considering e.g. details of intracellular compartments and atrial heterogeneity. On the pathological side, modeling atrial remodeling and fibrotic tissue are the other important aspects. The bridge to data that are measured in the catheter laboratory and on the body surface (ECG) is under construction. Every measurement can be used either for model personalization or for validation. Potential clinical applications are briefly outlined and future research perspectives are suggested.

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Studies of Therapeutic Strategies for Atrial Fibrillation Based on a Biophysical Model of the Human Atria

Cited by 2 publications

References 37 publications

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

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

Computational modeling of the human atrial anatomy and electrophysiology

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