title: The Spatiotemporal Stability of Dominant Frequency Sites in In-Silico Modeling of 3-Dimensional Left Atrial Mapping of Atrial Fibrillation.
abstract: BACKGROUND
  We previously reported that stable rotors were observed in in-silico human atrial fibrillation (AF) models, and were well represented by dominant frequency (DF). We explored the spatiotemporal stability of DF sites in 3D-AF models imported from patient CT images of the left atrium (LA).
  
  
  METHODS
  We integrated 3-D CT images of the LA obtained from ten patients with persistent AF (male 80%, 61.8 ± 13.5 years old) into an in-silico AF model. After induction, we obtained 6 seconds of AF simulation data for DF analyses in 30 second intervals (T1-T9). The LA was divided into ten sections. Spatiotemporal changes and variations in the temporal consistency of DF were evaluated at each section of the LA. The high DF area was defined as the area with the highest 10% DF.
  
  
  RESULTS
  1. There was no spatial consistency in the high DF distribution at each LA section during T1-T9 except in one patient (p = 0.027). 2. Coefficients of variation for the high DF area were highly different among the ten LA sections (p < 0.001), and they were significantly higher in the four pulmonary vein (PV) areas, the LA appendage, and the peri-mitral area than in the other LA sections (p < 0.001). 3. When we conducted virtual ablation of 10%, 15%, and 20% of the highest DF areas (n = 270 cases), AF was changed to atrial tachycardia (AT) or terminated at a rate of 40%, 57%, and 76%, respectively.
  
  
  CONCLUSIONS
  Spatiotemporal consistency of the DF area was observed in 10% of AF patients, and high DF areas were temporally variable. Virtual ablation of DF is moderately effective in AF termination and AF changing into AT.
authors.affiliation: Yonsei University Health System, Seoul, Republic of Korea.
authors.forename: Changyong
authors.initials: C
authors.lastname: Li
authors.affiliation: Yonsei University Health System, Seoul, Republic of Korea.
authors.forename: Byounghyun
authors.initials: B
authors.lastname: Lim
authors.affiliation: Yonsei University Health System, Seoul, Republic of Korea.
authors.forename: Minki
authors.initials: M
authors.lastname: Hwang
authors.affiliation: Yonsei University Health System, Seoul, Republic of Korea.
authors.forename: Jun-Seop
authors.initials: JS
authors.lastname: Song
authors.affiliation: Yonsei University Health System, Seoul, Republic of Korea.
authors.forename: Young-Seon
authors.initials: YS
authors.lastname: Lee
authors.affiliation: Yonsei University Health System, Seoul, Republic of Korea.
authors.forename: Boyoung
authors.initials: B
authors.lastname: Joung
authors.affiliation: Yonsei University Health System, Seoul, Republic of Korea.
authors.forename: Hui-Nam
authors.initials: HN
authors.lastname: Pak
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D066230:Patient-Specific Modeling; D049268:Positron-Emission Tomography