Simulating the role of anisotropy in human atrial cardioversion.
Simulating the role of anisotropy in human atrial cardioversion.
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模拟各向异性在人体心房复律中的作用。
DOI：
10.1109/embc.2013.6611128
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发表时间：
2013
期刊：
影响因子：
--
通讯作者：
Kharche SR
中科院分区：
文献类型：
--
作者：
Kharche SR
该计算研究量化了反馈控制的低能量心脏复律在各向异性人类心房中的有效性。采用已建立的生物物理人类细胞模型来再现对照和慢性心房颤动（CAF）动作电位。将细胞模型与详细的人类心房几何结构相结合，以构建3D逼真的人类心房模型。在Control和CAF条件下模拟滚动波，并评估用于滚动波终止的刺激强度和起搏持续时间的复律参数。在心房的两个位置启动涡卷波，以引起涡卷波位置的影响。通过与各向同性情况下的结果进行比较，突出了各向异性的作用。在控制条件下，涡卷波的自终止是迅速的各向异性的情况下。在CAF条件下，各向异性导致初始涡卷波退化成多个涡卷，每个涡卷不规则地演变或钉扎到解剖缺陷。心脏复律成功终止滚动波在10 s内，但刺激强度有很强的相关性的滚动波的位置。低能量刺激强度始终低于阈值刺激。心房电特性的各向异性起着重要的作用。各向异性加重CAF并导致高频心房起搏。心脏复律的有效性受到各向异性的显著影响。
This computational study quantifies the effectiveness of feedback controlled low energy cardioversion in the anisotropic human atria. An established biophysical human cell model was adopted to reproduce Control and chronic atrial fibrillation (CAF) action potentials. The cell model was combined with a detailed human atrial geometry to construct a 3D realistic human atrial model. Scroll waves were simulated under Control and CAF conditions and the cardioversion parameters of stimulation strength and pacing duration were evaluated for scroll wave termination. Scroll waves were initiated at two locations in the atria to elicit the effects of scroll wave location. The role of anisotropy was highlighted by comparison to results from the isotropic case. Under Control conditions, scroll wave self-termination was rapid in the anisotropic case. Under CAF conditions, anisotropy caused the initiated scroll wave to degenerate into multiple scrolls with each evolving erratically or pinning to anatomical defects. The cardioversion successfully terminated scroll waves within 10 s, but the stimulus strength had a strong correlation to the location of the scroll wave. The low energy stimulation strength was always lower than the threshold stimulus. Anisotropy plays an important role in atrial electrical properties. Anisotropy aggravates CAF and leads to high frequency atrial pacing. The efficacy of cardioversion is significantly affected by anisotropy.