Mostrar el registro sencillo del ítem

Novel Radiofrequency Ablation Strategies for Terminating Atrial Fibrillation in the Left Atrium: A Simulation Study

hal.structure.identifierModélisation et calculs pour l'électrophysiologie cardiaque [CARMEN]
dc.contributor.authorBAYER, Jason
hal.structure.identifierKing‘s College London
dc.contributor.authorRONEY, Caroline
hal.structure.identifierCenter for Computational Imaging and Simulation Technologies in Biomedicine [CISTIB]
dc.contributor.authorPASHAEI, Ali
hal.structure.identifierIHU-LIRYC
dc.contributor.authorJAÏS, Pierre
hal.structure.identifierModélisation et calculs pour l'électrophysiologie cardiaque [CARMEN]
dc.contributor.authorVIGMOND, Edward
dc.date.accessioned2024-04-04T02:51:14Z
dc.date.available2024-04-04T02:51:14Z
dc.date.issued2016-04-12
dc.identifier.issn1664-042X
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/191976
dc.description.abstractEnPulmonary vein isolation (PVI) with radiofrequency ablation (RFA) is the cornerstone of atrial fibrillation (AF) therapy, but few strategies exist for when it fails. To guide RFA, phase singularity (PS) mapping locates reentrant electrical waves (rotors) that perpetuate AF. The goal of this study was to test existing and develop new RFA strategies for terminating rotors identified with PS mapping. It is unsafe to test experimental RFA strategies in patients, so they were evaluated in silico using a bilayer computer model of the human atria with persistent AF (pAF) electrical (ionic) and structural (fibrosis) remodeling. pAF was initiated by rapidly pacing the right (RSPV) and left (LSPV) superior pulmonary veins during sinus rhythm, and rotor dynamics quantified by PS analysis. Three RFA strategies were studied: (i) PVI, roof, and mitral lines; (ii) circles, perforated circles, lines, and crosses 0.5-1.5 cm in diameter/length administered near rotor locations/pathways identified by PS mapping; and (iii) 4-8 lines streamlining the sequence of electrical activation during sinus rhythm. As in pAF patients, 2 ± 1 rotors with cycle length 185 ± 4 ms and short PS duration 452 ± 401 ms perpetuated simulated pAF. Spatially, PS density had weak to moderate positive correlations with fibrosis density (RSPV: r = 0.38, p = 0.35, LSPV: r = 0.77, p = 0.02). RFA PVI, mitral, and roof lines failed to terminate pAF, but RFA perforated circles and lines 1.5 cm in diameter/length terminated meandering rotors from RSPV pacing when placed at locations with high PS density. Similarly, RFA circles, perforated circles, and crosses 1.5 cm in diameter/length terminated stationary rotors from LSPV pacing. The most effective strategy for terminating pAF was to streamline the sequence of activation during sinus rhythm with >4 RFA lines. These results demonstrate that co-localizing 1.5 cm RFA lesions with locations of high PS density is a promising strategy for terminating pAF rotors. For patients immune to PVI, roof, mitral, and PS guided RFA strategies, streamlining patient-specific activation sequences during sinus rhythm is a robust but challenging alternative.
dc.description.sponsorshipPlateforme multi-modale d'exploration en cardiologie - ANR-11-EQPX-0030
dc.language.isoen
dc.publisherFrontiers
dc.subject.enablation
dc.subject.encomputer modeling
dc.subject.enfibrosis
dc.subject.enpersistent atrial fibrillation
dc.subject.enphase singularity mapping
dc.title.enNovel Radiofrequency Ablation Strategies for Terminating Atrial Fibrillation in the Left Atrium: A Simulation Study
dc.typeArticle de revue
dc.identifier.doi10.3389/fphys.2016.00108
dc.subject.halSciences du Vivant [q-bio]/Ingénierie biomédicale
dc.subject.halSciences du Vivant [q-bio]/Médecine humaine et pathologie/Cardiologie et système cardiovasculaire
bordeaux.journalFrontiers in Physiology
bordeaux.page108
bordeaux.volume7
bordeaux.hal.laboratoriesInstitut de Mathématiques de Bordeaux (IMB) - UMR 5251*
bordeaux.institutionUniversité de Bordeaux
bordeaux.institutionBordeaux INP
bordeaux.institutionCNRS
bordeaux.peerReviewedoui
hal.identifierhal-02886245
hal.version1
hal.popularnon
hal.audienceInternationale
hal.origin.linkhttps://hal.archives-ouvertes.fr//hal-02886245v1
bordeaux.COinSctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=Frontiers%20in%20Physiology&rft.date=2016-04-12&rft.volume=7&rft.spage=108&rft.epage=108&rft.eissn=1664-042X&rft.issn=1664-042X&rft.au=BAYER,%20Jason&RONEY,%20Caroline&PASHAEI,%20Ali&JA%C3%8FS,%20Pierre&VIGMOND,%20Edward&rft.genre=article


Archivos en el ítem

ArchivosTamañoFormatoVer

No hay archivos asociados a este ítem.

Este ítem aparece en la(s) siguiente(s) colección(ones)

Mostrar el registro sencillo del ítem