Effects of electrical and structural remodeling on atrial fibrillation maintenance: a simulation study.

Atrial fibrillation, a common cardiac arrhythmia, often progresses unfavourably: in patients with long-term atrial fibrillation, fibrillatory episodes are typically of increased duration and frequency of occurrence relative to healthy controls. This is due to electrical, structural, and contractile...

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Autores principales:	Trine Krogh-Madsen, Geoffrey W Abbott, David J Christini
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Biology (General) QH301-705.5
Acceso en línea:	https://doaj.org/article/d5e1779b4ad148299a55120c630d9782
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spelling	oai:doaj.org-article:d5e1779b4ad148299a55120c630d97822021-11-18T05:51:33ZEffects of electrical and structural remodeling on atrial fibrillation maintenance: a simulation study.1553-734X1553-735810.1371/journal.pcbi.1002390https://doaj.org/article/d5e1779b4ad148299a55120c630d97822012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22383869/?tool=EBIhttps://doaj.org/toc/1553-734Xhttps://doaj.org/toc/1553-7358Atrial fibrillation, a common cardiac arrhythmia, often progresses unfavourably: in patients with long-term atrial fibrillation, fibrillatory episodes are typically of increased duration and frequency of occurrence relative to healthy controls. This is due to electrical, structural, and contractile remodeling processes. We investigated mechanisms of how electrical and structural remodeling contribute to perpetuation of simulated atrial fibrillation, using a mathematical model of the human atrial action potential incorporated into an anatomically realistic three-dimensional structural model of the human atria. Electrical and structural remodeling both shortened the atrial wavelength--electrical remodeling primarily through a decrease in action potential duration, while structural remodeling primarily slowed conduction. The decrease in wavelength correlates with an increase in the average duration of atrial fibrillation/flutter episodes. The dependence of reentry duration on wavelength was the same for electrical vs. structural remodeling. However, the dynamics during atrial reentry varied between electrical, structural, and combined electrical and structural remodeling in several ways, including: (i) with structural remodeling there were more occurrences of fragmented wavefronts and hence more filaments than during electrical remodeling; (ii) dominant waves anchored around different anatomical obstacles in electrical vs. structural remodeling; (iii) dominant waves were often not anchored in combined electrical and structural remodeling. We conclude that, in simulated atrial fibrillation, the wavelength dependence of reentry duration is similar for electrical and structural remodeling, despite major differences in overall dynamics, including maximal number of filaments, wave fragmentation, restitution properties, and whether dominant waves are anchored to anatomical obstacles or spiralling freely.Trine Krogh-MadsenGeoffrey W AbbottDavid J ChristiniPublic Library of Science (PLoS)articleBiology (General)QH301-705.5ENPLoS Computational Biology, Vol 8, Iss 2, p e1002390 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Biology (General) QH301-705.5
spellingShingle	Biology (General) QH301-705.5 Trine Krogh-Madsen Geoffrey W Abbott David J Christini Effects of electrical and structural remodeling on atrial fibrillation maintenance: a simulation study.
description	Atrial fibrillation, a common cardiac arrhythmia, often progresses unfavourably: in patients with long-term atrial fibrillation, fibrillatory episodes are typically of increased duration and frequency of occurrence relative to healthy controls. This is due to electrical, structural, and contractile remodeling processes. We investigated mechanisms of how electrical and structural remodeling contribute to perpetuation of simulated atrial fibrillation, using a mathematical model of the human atrial action potential incorporated into an anatomically realistic three-dimensional structural model of the human atria. Electrical and structural remodeling both shortened the atrial wavelength--electrical remodeling primarily through a decrease in action potential duration, while structural remodeling primarily slowed conduction. The decrease in wavelength correlates with an increase in the average duration of atrial fibrillation/flutter episodes. The dependence of reentry duration on wavelength was the same for electrical vs. structural remodeling. However, the dynamics during atrial reentry varied between electrical, structural, and combined electrical and structural remodeling in several ways, including: (i) with structural remodeling there were more occurrences of fragmented wavefronts and hence more filaments than during electrical remodeling; (ii) dominant waves anchored around different anatomical obstacles in electrical vs. structural remodeling; (iii) dominant waves were often not anchored in combined electrical and structural remodeling. We conclude that, in simulated atrial fibrillation, the wavelength dependence of reentry duration is similar for electrical and structural remodeling, despite major differences in overall dynamics, including maximal number of filaments, wave fragmentation, restitution properties, and whether dominant waves are anchored to anatomical obstacles or spiralling freely.
format	article
author	Trine Krogh-Madsen Geoffrey W Abbott David J Christini
author_facet	Trine Krogh-Madsen Geoffrey W Abbott David J Christini
author_sort	Trine Krogh-Madsen
title	Effects of electrical and structural remodeling on atrial fibrillation maintenance: a simulation study.
title_short	Effects of electrical and structural remodeling on atrial fibrillation maintenance: a simulation study.
title_full	Effects of electrical and structural remodeling on atrial fibrillation maintenance: a simulation study.
title_fullStr	Effects of electrical and structural remodeling on atrial fibrillation maintenance: a simulation study.
title_full_unstemmed	Effects of electrical and structural remodeling on atrial fibrillation maintenance: a simulation study.
title_sort	effects of electrical and structural remodeling on atrial fibrillation maintenance: a simulation study.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/d5e1779b4ad148299a55120c630d9782
work_keys_str_mv	AT trinekroghmadsen effectsofelectricalandstructuralremodelingonatrialfibrillationmaintenanceasimulationstudy AT geoffreywabbott effectsofelectricalandstructuralremodelingonatrialfibrillationmaintenanceasimulationstudy AT davidjchristini effectsofelectricalandstructuralremodelingonatrialfibrillationmaintenanceasimulationstudy
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Effects of electrical and structural remodeling on atrial fibrillation maintenance: a simulation study.

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