title: Patient-specific modeling of atrial fibrosis increases the accuracy of sinus rhythm simulations and may explain maintenance of atrial fibrillation.
abstract: Left atrial fibrosis is thought to contribute to the manifestation of atrial fibrillation (AF). Late Gadolinium enhancement (LGE) MRI has the potential to image regions of low perfusion, which can be related to fibrosis. We show that a simulation with a patient-specific model including left atrial regional fibrosis derived from LGE-MRI reproduces local activation in the left atrium more precisely than the regular simulation without fibrosis. AF simulations showed a spontaneous termination of the arrhythmia in the absence of fibrosis and a stable rotor center in the presence of fibrosis. The methodology may provide a tool for a deeper understanding of the mechanisms maintaining AF and eventually also for the planning of substrate-guided ablation procedures in the future.
authors: Institute of Biomedical Engineering, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany. Electronic address: publications@ibt.kit.edu.
authors: Martin W
authors: MW
authors: Krueger
authors: Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom.
authors: Kawal S
authors: KS
authors: Rhode
authors: Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom.
authors: Mark D
authors: MD
authors: O'Neill
authors: Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom.
authors: C Aldo
authors: CA
authors: Rinaldi
authors: Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom.
authors: Jaswinder
authors: J
authors: Gill
authors: Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom.
authors: Reza
authors: R
authors: Razavi
authors: Institute of Biomedical Engineering, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany.
authors: Gunnar
authors: G
authors: Seemann
authors: Institute of Biomedical Engineering, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany.
authors: Olaf
authors: O
authors: Doessel
mesh_terms: D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology*; D004562:Electrocardiography / Q000379:methods; D005355:Fibrosis / Q000473:pathology / Q000503:physiopathology; D006325:Heart Atria / Q000473:pathology* / Q000503:physiopathology*; D006329:Heart Conduction System / Q000503:physiopathology*; D006339:Heart Rate; D006801:Humans; D008955:Models, Cardiovascular; D066230:Patient-Specific Modeling; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: Atrial fibrillation; Atrial fibrosis; Computational modeling; Late enhance MRI