ArticleEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2018
Arrhythmia dynamics in computational models of the atria following virtual ablation of re-entrant drivers.
Article in Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed.
- The Hodgkin-Huxley-Katz Prize Lecture: Heart digital twins: A new paradigm in arrhythmia medicine.The Journal of physiology · 2026Article
- Transmural heterogeneity in 3D fibrosis distribution is associated with endo-epicardial electrical dyssynchrony in persistent atrial fibrillation.The Journal of physiology · 2026Article
- Towards mechanisms-driven strategy for persistent atrial fibrillation ablation: Leveraging digital twins.Journal of precision medicine (Amsterdam, Netherlands) · 2026Article
- The effect of clinically relevant changes in extracellular electrolyte concentrations on human atrial arrhythmias.Communications medicine · 2025Article
- Predicting arrhythmia recurrence post-ablation in atrial fibrillation using explainable machine learning.Communications medicine · 2025Article
- Digital Twin Models in Atrial Fibrillation: Charting the Future of Precision Therapy?Journal of personalized medicine · 2025Review
- Impact of effective refractory period personalization on arrhythmia vulnerability in patient-specific atrial computer models.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024Article
- Assessing the arrhythmogenic propensity of fibrotic substrate using digital twins to inform a mechanisms-based atrial fibrillation ablation strategy.Nature cardiovascular research · 2024Article
- Up digital and personal: How heart digital twins can transform heart patient care.Heart rhythm · 2024Review
- Computational Modeling and Simulation of the Fibrotic Human Atria.Methods in molecular biology (Clifton, N.J.) · 2024Article
- 25 years of basic and translational science in EP Europace: novel insights into arrhythmia mechanisms and therapeutic strategies.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Review
- Explainable Machine Learning to Predict Anchored Reentry Substrate Created by Persistent Atrial Fibrillation Ablation in Computational Models.Journal of the American Heart Association · 2023Article
- The influence of metabolic syndrome on atrial fibrillation recurrence: five-year outcomes after a single cryoballoon ablation procedure.Journal of geriatric cardiology : JGC · 2021Article
- Current progress of computational modeling for guiding clinical atrial fibrillation ablation.Journal of Zhejiang University. Science. B · 2021Review
- Computational models of atrial fibrillation: achievements, challenges, and perspectives for improving clinical care.Cardiovascular research · 2021Review
- Article
- Characterizing the arrhythmogenic substrate in personalized models of atrial fibrillation: sensitivity to mesh resolution and pacing protocol in AF models.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2021Article
- Computationally guided personalized targeted ablation of persistent atrial fibrillation.Nature biomedical engineering · 2019Article
- Arrhythmogenic propensity of the fibrotic substrate after atrial fibrillation ablation: a longitudinal study using magnetic resonance imaging-based atrial models.Cardiovascular research · 2019Article
- The role of personalized atrial modeling in understanding atrial fibrillation mechanisms and improving treatment.International journal of cardiology · 2019Review
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4 authors.
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Abstract
aimsEfforts to improve ablation success rates in persistent atrial fibrillation (AF) patients by targeting re-entrant driver (RD) sites have been hindered by weak mechanistic understanding regarding emergent RDs localization following initial fibrotic substrate modification. This study aimed to systematically assess arrhythmia dynamics after virtual ablation of RD sites in computational models. METHODS AND
resultsSimulations were conducted in 12 patient-specific atrial models reconstructed from pre-procedure late gadolinium-enhanced magnetic resonance imaging scans. In a previous study involving these same models, we comprehensively characterized pre-ablation RDs in simulations conducted with either 'average human AF'-based electrophysiology (i.e. EPavg) or ±10% action potential duration or conduction velocity (i.e. EPvar). Re-entrant drivers seen under the EPavg condition were virtually ablated and the AF initiation protocol was re-applied. Twenty-one emergent RDs were observed in 9/12 atrial models (1.75 ± 1.35 emergent RDs per model); these dynamically localized to boundary regions between fibrotic and non-fibrotic tissue. Most emergent RD locations (15/21, 71.4%) were within 0.1 cm of sites where RDs were seen pre-ablation in simulations under EPvar conditions. Importantly, this suggests that the level of uncertainty in our models' ability to predict patient-specific ablation targets can be substantially mitigated by running additional simulations that include virtual ablation of RDs. In 7/12 atrial models, at least one episode of macro-reentry around ablation lesion(s) was observed.
conclusionArrhythmia episodes after virtual RD ablation are perpetuated by both emergent RDs and by macro-reentrant circuits formed around lesions. Custom-tailoring of ablation procedures based on models should take steps to mitigate these sources of AF recurrence.
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