title: Methodology for patient-specific modeling of atrial fibrosis as a substrate for atrial fibrillation.
abstract: Personalized computational cardiac models are emerging as an important tool for studying cardiac arrhythmia mechanisms, and have the potential to become powerful instruments for guiding clinical anti-arrhythmia therapy. In this article, we present the methodology for constructing a patient-specific model of atrial fibrosis as a substrate for atrial fibrillation. The model is constructed from high-resolution late gadolinium-enhanced magnetic resonance imaging (LGE-MRI) images acquired in vivo from a patient suffering from persistent atrial fibrillation, accurately capturing both the patient's atrial geometry and the distribution of the fibrotic regions in the atria. Atrial fiber orientation is estimated using a novel image-based method, and fibrosis is represented in the patient-specific fibrotic regions as incorporating collagenous septa, gap junction remodeling, and myofibroblast proliferation. A proof-of-concept simulation result of reentrant circuits underlying atrial fibrillation in the model of the patient's fibrotic atrium is presented to demonstrate the completion of methodology development.
authors.affiliation: The Johns Hopkins University, Department of Biomedical Engineering and Institute for Computational Medicine, Baltimore, MD, USA. kmcdowe4@jhmi.edu
authors.forename: Kathleen S
authors.initials: KS
authors.lastname: McDowell
authors.forename: Fijoy
authors.initials: F
authors.lastname: Vadakkumpadan
authors.forename: Robert
authors.initials: R
authors.lastname: Blake
authors.forename: Joshua
authors.initials: J
authors.lastname: Blauer
authors.forename: Gernot
authors.initials: G
authors.lastname: Plank
authors.forename: Rob S
authors.initials: RS
authors.lastname: MacLeod
authors.forename: Natalia A
authors.initials: NA
authors.lastname: Trayanova
mesh_terms: D000200:Action Potentials; D001281:Atrial Fibrillation / Q000473:pathology / Q000503:physiopathology*; D003198:Computer Simulation; D005355:Fibrosis; D006325:Heart Atria / Q000473:pathology* / Q000503:physiopathology*; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008955:Models, Cardiovascular; D018802:Patient-Centered Care / Q000379:methods*; D010865:Pilot Projects