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Variability in pulmonary vein electrophysiology and fibrosis determines arrhythmia susceptibility and dynamics

hal.structure.identifierIHU-LIRYC
dc.contributor.authorRONEY, Caroline
hal.structure.identifierModélisation et calculs pour l'électrophysiologie cardiaque [CARMEN]
dc.contributor.authorBAYER, Jason
hal.structure.identifierIHU-LIRYC
dc.contributor.authorCOCHET, Hubert
hal.structure.identifierIHU-LIRYC
dc.contributor.authorMEO, Marianna
hal.structure.identifierIHU-LIRYC
dc.contributor.authorDUBOIS, Rémi
hal.structure.identifierIHU-LIRYC
dc.contributor.authorJAÏS, Pierre
hal.structure.identifierModélisation et calculs pour l'électrophysiologie cardiaque [CARMEN]
dc.contributor.authorVIGMOND, Edward
dc.date.accessioned2024-04-04T02:51:30Z
dc.date.available2024-04-04T02:51:30Z
dc.date.issued2018-05-24
dc.identifier.issn1553-734X
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/191991
dc.description.abstractEnSuccess rates for catheter ablation of persistent atrial fibrillation patients are currently low; however, there is a subset of patients for whom electrical isolation of the pulmonary veins alone is a successful treatment strategy. It is difficult to identify these patients because there are a multitude of factors affecting arrhythmia susceptibility and maintenance, and the individual contributions of these factors are difficult to determine clinically. We hypothesised that the combination of pulmonary vein (PV) electrophysiology and atrial body fibrosis determine driver location and effectiveness of pulmonary vein isolation (PVI). We used bilayer biatrial computer models based on patient geometries to investigate the effects of PV properties and atrial fibrosis on arrhythmia inducibility, maintenance mechanisms, and the outcome of PVI. Short PV action potential duration (APD) increased arrhythmia susceptibility, while longer PV APD was found to be protective. Arrhythmia inducibility increased with slower conduction velocity (CV) at the LA/PV junction, but not for cases with homogeneous CV changes or slower CV at the distal PV. Phase singularity (PS) density in the PV region for cases with PV fibrosis was increased. Arrhythmia dynamics depend on both PV properties and fibrosis distribution, varying from meandering rotors to PV reentry (in cases with baseline or long APD), to stable rotors at regions of high fibrosis density. Measurement of fibrosis and PV properties may indicate patient specific susceptibility to AF initiation and maintenance. PV PS density before PVI was higher for cases in which AF terminated or converted to a macroreentry; thus, high PV PS density may indicate likelihood of PVI success.
dc.description.sponsorshipDissection génétique de la Susceptibilité Mendélienne aux infections mycobactériennes chez l'homme - ANR-16-CE17-0005
dc.description.sponsorshipStimulation de surface étendue à faible intensité (WAYLESS): une nouvelle thérapie pour terminer les arythmies cardiaques létales - ANR-16-CE19-0009
dc.language.isoen
dc.publisherPublic Library of Science
dc.title.enVariability in pulmonary vein electrophysiology and fibrosis determines arrhythmia susceptibility and dynamics
dc.typeArticle de revue
dc.identifier.doi10.1371/journal.pcbi.1006166
dc.subject.halSciences du Vivant [q-bio]/Médecine humaine et pathologie/Cardiologie et système cardiovasculaire
bordeaux.journalPLoS Computational Biology
bordeaux.pagee1006166
bordeaux.volume14
bordeaux.hal.laboratoriesInstitut de Mathématiques de Bordeaux (IMB) - UMR 5251*
bordeaux.issue5
bordeaux.institutionUniversité de Bordeaux
bordeaux.institutionBordeaux INP
bordeaux.institutionCNRS
bordeaux.peerReviewedoui
hal.identifierhal-02885638
hal.version1
hal.popularnon
hal.audienceInternationale
hal.origin.linkhttps://hal.archives-ouvertes.fr//hal-02885638v1
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