In-silico modeling of atrial repolarization in normal and atrial fibrillation remodeled state
In-silico modeling of atrial repolarization in normal and atrial fibrillation remodeled state
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DOI：
10.1007/s11517-013-1090-1
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发表时间：
2013-10-01
影响因子：
3.2
通讯作者：
Doessel, Olaf
中科院分区：
文献类型：
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作者：
Krueger, Martin W.;Dorn, Andreas;Doessel, Olaf
心房颤动（AF）是最常见的心律失常，AF患者总数不断增加。导致和维持房颤的机制尚未完全了解。心房电生理学的异质性似乎在这方面发挥着重要作用。尽管一些异质性已用于计算机人体心房模型研究，但尚未得到彻底研究。在这项研究中，Courtemanche 等人、Nygren 等人的原始电生理 (EP) 模型。和马莱卡等人。进行调整以重现 13 个心房区域的动作电位。根据来自房室传导阻滞患者的实验动作电位持续时间数据和心电图数据对参数集进行了验证。异质 EP 模型的使用使得各种 3D 心房解剖模型中的复极序列更加同步。异质 EP 模型与持续 AF 重塑电生理学模型的结合导致了细胞电生理学的巨大变化。模拟的 Ta 波在重构下显着缩短。细胞电生理学的异质性解释了先前观察到的 Ta 波效应。该结果标志着向心房复极序列的可靠模拟迈出了重要的一步，使人们更深入地了解心房复极机制并使得进一步的临床研究成为可能。
Atrial fibrillation (AF) is the most common cardiac arrhythmia, and the total number of AF patients is constantly increasing. The mechanisms leading to and sustaining AF are not completely understood yet. Heterogeneities in atrial electrophysiology seem to play an important role in this context. Although some heterogeneities have been used in in-silico human atrial modeling studies, they have not been thoroughly investigated. In this study, the original electrophysiological (EP) models of Courtemanche et al., Nygren et al. and Maleckar et al. were adjusted to reproduce action potentials in 13 atrial regions. The parameter sets were validated against experimental action potential duration data and ECG data from patients with AV block. The use of the heterogeneous EP model led to a more synchronized repolarization sequence in a variety of 3D atrial anatomical models. Combination of the heterogeneous EP model with a model of persistent AF-remodeled electrophysiology led to a drastic change in cell electrophysiology. Simulated Ta-waves were significantly shorter under the remodeling. The heterogeneities in cell electrophysiology explain the previously observed Ta-wave effects. The results mark an important step toward the reliable simulation of the atrial repolarization sequence, give a deeper understanding of the mechanism of atrial repolarization and enable further clinical investigations.