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
Patient-specific simulations predict efficacy of ablation of interatrial connections for treatment of persistent atrial fibrillation.
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 26 papers.
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Who cites it
26 citing papers in PubMed.
- In silico predictions of action potential propagation in doxorubicin cardiotoxicity: A parametric study using preclinical 3D magnetic resonance imaging-based fibrotic left ventricle models.The Journal of physiology · 2026Article
- Role of interatrial connection ablation in re-entry dynamics: an in silico evaluation.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 · 2026Article
- Generating patient-specific computational models with point cloud data from human atrial electrophysiology studies.PloS one · 2026Article
- 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
- Computational modeling of cardiac electrophysiology and arrhythmogenesis: toward clinical translation.Physiological reviews · 2024Review
- A Review of Personalised Cardiac Computational Modelling Using Electroanatomical Mapping Data.Arrhythmia & electrophysiology review · 2024Review
- Computational Modeling and Simulation of the Fibrotic Human Atria.Methods in molecular biology (Clifton, N.J.) · 2024Article
- Constructing bilayer and volumetric atrial models at scale.Interface focus · 2023Article
- Comparing Inducibility of Re-Entrant Arrhythmia in Patient-Specific Computational Models to Clinical Atrial Fibrillation Phenotypes.JACC. Clinical electrophysiology · 2023Article
- Detection of focal source and arrhythmogenic substrate from body surface potentials to guide atrial fibrillation ablation.PLoS computational biology · 2022Article
- Predicting Atrial Fibrillation Recurrence by Combining Population Data and Virtual Cohorts of Patient-Specific Left Atrial Models.Circulation. Arrhythmia and electrophysiology · 2022Article
- Rule-based definition of muscle bundles in patient-specific models of the left atrium.Frontiers in physiology · 2022Article
- Basic Research Approaches to Evaluate Cardiac Arrhythmia in Heart Failure and Beyond.Frontiers in physiology · 2022Review
- Applications of multimodality imaging for left atrial catheter ablation.European heart journal. Cardiovascular Imaging · 2021Review
- The Effect of Diabetes Mellitus on the Recurrence of Atrial Fibrillation after Ablation.Journal of clinical medicine · 2021Article
- Current progress of computational modeling for guiding clinical atrial fibrillation ablation.Journal of Zhejiang University. Science. B · 2021Review
- Article
- Review
- 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
- Toward Patient-Specific Prediction of Ablation Strategies for Atrial Fibrillation Using Deep Learning.Frontiers in physiology · 2021Article
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Authors and funding
12 authors.
Funding
Abstract
aimsTreatments for persistent atrial fibrillation (AF) offer limited efficacy. One potential strategy aims to return the right atrium (RA) to sinus rhythm (SR) by ablating interatrial connections (IAC) to isolate the atria, but there is limited clinical data to evaluate this ablation approach. We aimed to use simulation to evaluate and predict patient-specific suitability for ablation of IAC to treat AF. METHODS AND
resultsPersistent AF was simulated in 12 patient-specific geometries, incorporating electrophysiological heterogeneity and fibres, with IAC at Bachmann's bundle, the coronary sinus, and fossa ovalis. Simulations were performed to test the effect of left atrial (LA)-to-RA frequency gradient and fibrotic remodelling on IAC ablation efficacy. During AF, we simulated ablation of one, two, or all three IAC, with or without pulmonary vein isolation and determined if this altered or terminated the arrhythmia. For models without structural remodelling, ablating all IAC terminated RA arrhythmia in 83% of cases. Models with the LA-to-RA frequency gradient removed had an increased success rate (100% success). Ablation of IACs is less effective in cases with fibrotic remodelling (interstitial fibrosis 50% success rate; combination remodelling 67%). Mean number of phase singularities in the RA was higher pre-ablation for IAC failure (success 0.6 ± 0.8 vs. failure 3.2 ± 2.5, P < 0.001).
conclusionThis simulation study predicts that IAC ablation is effective in returning the RA to SR for many cases. Patient-specific modelling approaches have the potential to stratify patients prior to ablation by predicting if drivers are located in the LA or RA. We present a platform for predicting efficacy and informing patient selection for speculative treatments.
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