ArticleFrontiers in physiology2021
A Reproducible Protocol to Assess Arrhythmia Vulnerability
Article in Frontiers in physiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 30 citations in OpenAlex.
- 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
- In silico assessment of arrhythmic risk following the implantation of engineered heart tissues in porcine hearts with varying infarct locations.PLoS computational biology · 2026Article
- Automated generation of ablation lesion masks: a unison of electro and optic flow mapping for persistent AF virtual cohorts.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
- Computational modelling of biological systems now and then: revisiting tools and visions from the beginning of the century.Philosophical transactions. Series A, Mathematical, physical, and engineering sciences · 2025Review
- Clinical usefulness of digital twin guided virtual amiodarone test in patients with atrial fibrillation ablation.NPJ digital medicine · 2024Article
- 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
- Effects of hydroxychloroquine on atrial electrophysiology in in silico wild-type and PITX2Herz · 2023Article
- Evaluation of an open-source pipeline to create patient-specific left atrial models: A reproducibility study.Computers in biology and medicine · 2023Article
- Personalized ablation vs. conventional ablation strategies to terminate atrial fibrillation and prevent recurrence.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 · 2023Article
- Predicting Atrial Fibrillation Recurrence by Combining Population Data and Virtual Cohorts of Patient-Specific Left Atrial Models.Circulation. Arrhythmia and electrophysiology · 2022Article
- Fast Characterization of Inducible Regions of Atrial Fibrillation Models With Multi-Fidelity Gaussian Process Classification.Frontiers in physiology · 2022Article
- How synergy between mechanistic and statistical models is impacting research in atrial fibrillation.Frontiers in physiology · 2022Review
- Non-Invasive and Quantitative Estimation of Left Atrial Fibrosis Based on P Waves of the 12-Lead ECG-A Large-Scale Computational Study Covering Anatomical Variability.Journal of clinical medicine · 2021Article
- Time-Averaged Wavefront Analysis Demonstrates Preferential Pathways of Atrial Fibrillation, Predicting Pulmonary Vein Isolation Acute Response.Frontiers in physiology · 2021Article
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
In both clinical and computational studies, different pacing protocols are used to induce arrhythmia and non-inducibility is often considered as the endpoint of treatment. The need for a standardized methodology is urgent since the choice of the protocol used to induce arrhythmia could lead to contrasting results, e.g., in assessing atrial fibrillation (AF) vulnerabilty. Therefore, we propose a novel method-pacing at the end of the effective refractory period (PEERP)-and compare it to state-of-the-art protocols, such as phase singularity distribution (PSD) and rapid pacing (RP) in a computational study. All methods were tested by pacing from evenly distributed endocardial points at 1 cm inter-point distance in two bi-atrial geometries. Seven different atrial models were implemented: five cases without specific AF-induced remodeling but with decreasing global conduction velocity and two persistent AF cases with an increasing amount of fibrosis resembling different substrate remodeling stages. Compared with PSD and RP, PEERP induced a larger variety of arrhythmia complexity requiring, on average, only 2.7 extra-stimuli and 3 s of simulation time to initiate reentry. Moreover, PEERP and PSD were the protocols which unveiled a larger number of areas vulnerable to sustain stable long living reentries compared to RP. Finally, PEERP can foster standardization and reproducibility, since, in contrast to the other protocols, it is a parameter-free method. Furthermore, we discuss its clinical applicability. We conclude that the choice of the inducing protocol has an influence on both initiation and maintenance of AF and we propose and provide PEERP as a reproducible method to assess arrhythmia vulnerability.
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