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Comparing Reentrant Drivers Predicted by Image-Based Computational Modeling and Mapped by Electrocardiographic Imaging in Persistent Atrial Fibrillation

hal.structure.identifierJohns Hopkins University [JHU]
dc.contributor.authorBOYLE, Patrick
hal.structure.identifierJohns Hopkins University [JHU]
dc.contributor.authorHAKIM, Joe
hal.structure.identifierJohns Hopkins University [JHU]
dc.contributor.authorZAHID, Sohail
hal.structure.identifierJohns Hopkins University [JHU]
dc.contributor.authorFRANCESCHI, William
hal.structure.identifierMedical Research Council
dc.contributor.authorMURPHY, Michael
hal.structure.identifierModélisation et calculs pour l'électrophysiologie cardiaque [CARMEN]
dc.contributor.authorVIGMOND, Edward
hal.structure.identifierIHU-LIRYC
dc.contributor.authorDUBOIS, Rémi
hal.structure.identifierIHU-LIRYC
dc.contributor.authorHAÏSSAGUERRE, Michel
hal.structure.identifierIHU-LIRYC
dc.contributor.authorHOCINI, Mélèze
hal.structure.identifierIHU-LIRYC
dc.contributor.authorJAÏS, Pierre
hal.structure.identifierJohns Hopkins University [JHU]
dc.contributor.authorTRAYANOVA, Natalia
hal.structure.identifierIHU-LIRYC
dc.contributor.authorCOCHET, Hubert
dc.date.accessioned2024-04-04T02:51:27Z
dc.date.available2024-04-04T02:51:27Z
dc.date.issued2018-04-19
dc.identifier.issn1664-042X
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/191989
dc.description.abstractEnElectrocardiographic mapping (ECGI) detects reentrant drivers (RDs) that perpetuate arrhythmia in persistent AF (PsAF). Patient-specific computational models derived from late gadolinium-enhanced magnetic resonance imaging (LGE-MRI) identify all latent sites in the fibrotic substrate that could potentially sustain RDs, not just those manifested during mapped AF. The objective of this study was to compare RDs from simulations and ECGI (RDsim/RDECGI) and analyze implications for ablation. We considered 12 PsAF patients who underwent RDECGI ablation. For the same cohort, we simulated AF and identified RDsim sites in patient-specific models with geometry and fibrosis distribution from pre-ablation LGE-MRI. RDsim- and RDECGI-harboring regions were compared, and the extent of agreement between macroscopic locations of RDs identified by simulations and ECGI was assessed. Effects of ablating RDECGI/RDsim were analyzed. RDsim were predicted in 28 atrial regions (median [inter-quartile range (IQR)] = 3.0 [1.0; 3.0] per model). ECGI detected 42 RDECGI-harboring regions (4.0 [2.0; 5.0] per patient). The number of regions with RDsim and RDECGI per individual was not significantly correlated (R = 0.46, P = ns). The overall rate of regional agreement was fair (modified Cohen's κ0 statistic = 0.11), as expected, based on the different mechanistic underpinning of RDsim- and RDECGI. nineteen regions were found to harbor both RDsim and RDECGI, suggesting that a subset of clinically observed RDs was fibrosis-mediated. The most frequent source of differences (23/32 regions) between the two modalities was the presence of RDECGI perpetuated by mechanisms other than the fibrotic substrate. In 6/12 patients, there was at least one region where a latent RD was observed in simulations but was not manifested during clinical mapping. Ablation of fibrosis-mediated RDECGI (i.e., targets in regions that also harbored RDsim) trended toward a higher rate of positive response compared to ablation of other RDECGI targets (57 vs. 41%, P = ns). Our analysis suggests that RDs in human PsAF are at least partially fibrosis-mediated. Substrate-based ablation combining simulations with ECGI could improve outcomes.
dc.description.sponsorshipPlateforme multi-modale d'exploration en cardiologie - ANR-11-EQPX-0030
dc.language.isoen
dc.publisherFrontiers
dc.subject.enAblation
dc.subject.enComputational modeling
dc.subject.enElectrocardiographic mapping
dc.subject.enReentrant drivers
dc.subject.enAtrial fibrillation
dc.subject.enFibrotic remodeling
dc.title.enComparing Reentrant Drivers Predicted by Image-Based Computational Modeling and Mapped by Electrocardiographic Imaging in Persistent Atrial Fibrillation
dc.typeArticle de revue
dc.identifier.doi10.3389/fphys.2018.00414
dc.subject.halSciences du Vivant [q-bio]/Médecine humaine et pathologie/Cardiologie et système cardiovasculaire
dc.subject.halSciences du Vivant [q-bio]/Ingénierie biomédicale
bordeaux.journalFrontiers in Physiology
bordeaux.page414
bordeaux.volume9
bordeaux.hal.laboratoriesInstitut de Mathématiques de Bordeaux (IMB) - UMR 5251*
bordeaux.institutionUniversité de Bordeaux
bordeaux.institutionBordeaux INP
bordeaux.institutionCNRS
bordeaux.peerReviewedoui
hal.identifierhal-02885640
hal.version1
hal.popularnon
hal.audienceInternationale
hal.origin.linkhttps://hal.archives-ouvertes.fr//hal-02885640v1
bordeaux.COinSctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=Frontiers%20in%20Physiology&rft.date=2018-04-19&rft.volume=9&rft.spage=414&rft.epage=414&rft.eissn=1664-042X&rft.issn=1664-042X&rft.au=BOYLE,%20Patrick&HAKIM,%20Joe&ZAHID,%20Sohail&FRANCESCHI,%20William&MURPHY,%20Michael&rft.genre=article


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