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Epicardial Fibrosis Explains Increased Endo–Epicardial Dissociation and Epicardial Breakthroughs in Human Atrial Fibrillation

hal.structure.identifierCenter for Computational Medicine in Cardiology [Lugano]
dc.contributor.authorGHARAVIRI, Ali
hal.structure.identifierMaastricht University Medical Centre [MUMC]
dc.contributor.authorBIDAR, Elham
hal.structure.identifierIHU-LIRYC
hal.structure.identifierModélisation et calculs pour l'électrophysiologie cardiaque [CARMEN]
hal.structure.identifierInstitut de Mathématiques de Bordeaux [IMB]
dc.contributor.authorPOTSE, Mark
hal.structure.identifierMaastricht University [Maastricht]
dc.contributor.authorZEEMERING, Stef
hal.structure.identifierMaastricht University [Maastricht]
dc.contributor.authorVERHEULE, Sander
hal.structure.identifierFaculty of Informatics [Lugano]
hal.structure.identifierCenter for Computational Medicine in Cardiology [CCMC]
dc.contributor.authorPEZZUTO, Simone
hal.structure.identifierCenter for Computational Medicine in Cardiology [Lugano]
dc.contributor.authorKRAUSE, Rolf
hal.structure.identifierMaastricht University Medical Centre [MUMC]
dc.contributor.authorMAESSEN, Jos
hal.structure.identifierCenter for Computational Medicine in Cardiology [Lugano]
hal.structure.identifierFondazione Cardiocentro Ticino
dc.contributor.authorAURICCHIO, Angelo
hal.structure.identifierDepartment of Physiology [Maastricht]
dc.contributor.authorSCHOTTEN, Ulrich
dc.date.accessioned2024-04-04T02:56:29Z
dc.date.available2024-04-04T02:56:29Z
dc.date.issued2020-02-21
dc.identifier.issn1664-042X
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/192468
dc.description.abstractEnBackground: Atrial fibrillation (AF) is accompanied by progressive epicardial fibrosis, dissociation of electrical activity between the epicardial layer and the endocardial bundle network, and transmural conduction (breakthroughs). However, causal relationships between these phenomena have not been demonstrated yet. Our goal was to test the hypothesis that epicardial fibrosis suffices to increase endo–epicardial dissociation (EED) and breakthroughs (BT) during AF.Methods: We simulated the effect of fibrosis in the epicardial layer on EED and BT in a detailed, high-resolution, three-dimensional model of the human atria with realistic electrophysiology. The model results were compared with simultaneous endo–epicardial mapping in human atria. The model geometry, specifically built for this study, was based on MR images and histo-anatomical studies. Clinical data were obtained in four patients with longstanding persistent AF (persAF) and three patients without a history of AF.Results: The AF cycle length (AFCL), conduction velocity (CV), and EED were comparable in the mapping studies and the simulations. EED increased from 24.1 ± 3.4 to 56.58 ± 6.2% (p < 0.05), and number of BTs per cycle from 0.89 ± 0.55 to 6.74 ± 2.11% (p < 0.05), in different degrees of fibrosis in the epicardial layer. In both mapping data and simulations, EED correlated with prevalence of BTs. Fibrosis also increased the number of fibrillation waves per cycle in the model.Conclusion: A realistic 3D computer model of AF in which epicardial fibrosis was increased, in the absence of other pathological changes, showed increases in EED and epicardial BT comparable to those in longstanding persAF. Thus, epicardial fibrosis can explain both phenomena.
dc.language.isoen
dc.publisherFrontiers
dc.rights.urihttp://creativecommons.org/licenses/by/
dc.subject.enAtrial fibrillation
dc.subject.enComputer models
dc.subject.enFibrosis
dc.subject.enTransmural conduction
dc.subject.enEED
dc.subject.enBreakthrough waves
dc.title.enEpicardial Fibrosis Explains Increased Endo–Epicardial Dissociation and Epicardial Breakthroughs in Human Atrial Fibrillation
dc.typeArticle de revue
dc.identifier.doi10.3389/fphys.2020.00068
dc.subject.halSciences du Vivant [q-bio]/Médecine humaine et pathologie/Cardiologie et système cardiovasculaire
bordeaux.journalFrontiers in Physiology
bordeaux.page68
bordeaux.volume11
bordeaux.hal.laboratoriesInstitut de Mathématiques de Bordeaux (IMB) - UMR 5251*
bordeaux.institutionUniversité de Bordeaux
bordeaux.institutionBordeaux INP
bordeaux.institutionCNRS
bordeaux.peerReviewedoui
hal.identifierhal-02487118
hal.version1
hal.popularnon
hal.audienceInternationale
hal.origin.linkhttps://hal.archives-ouvertes.fr//hal-02487118v1
bordeaux.COinSctx_ver=Z39.88-2004&amp;rft_val_fmt=info:ofi/fmt:kev:mtx:journal&amp;rft.jtitle=Frontiers%20in%20Physiology&amp;rft.date=2020-02-21&amp;rft.volume=11&amp;rft.spage=68&amp;rft.epage=68&amp;rft.eissn=1664-042X&amp;rft.issn=1664-042X&amp;rft.au=GHARAVIRI,%20Ali&amp;BIDAR,%20Elham&amp;POTSE,%20Mark&amp;ZEEMERING,%20Stef&amp;VERHEULE,%20Sander&amp;rft.genre=article


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