Effectiveness of atrial fibrillation rotor ablation is dependent on conduction velocity: An in-silico 3-dimensional modeling study.
Effectiveness of atrial fibrillation rotor ablation is dependent on conduction velocity: An in-silico 3-dimensional modeling study.
复制标题
DOI：
10.1371/journal.pone.0190398
复制
发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Pak HN
中科院分区：
文献类型：
--
作者：
Lim B;Hwang M;Song JS;Ryu AJ;Joung B;Shim EB;Ryu H;Pak HN
我们以前报道过，在计算机模拟的人类房颤（AF）模型中观察到稳定的转子，并且由主频率（DF）很好地表示。在本研究中，我们假设DF消融的结果受传导速度（CV）条件的影响，并使用计算机3D-AF建模检查了这一假设。我们将10例持续性房颤患者（80%男性，61.8±13.5岁）的左心房三维CT图像整合到计算机模拟房颤模型中。我们比较了5种不同CV条件（0.2、0.3、0.4、0.5和0.6 m/s）下虚拟DF消融后AF维持时间（最长300 s）、DF时空稳定性、相位奇点（PS）数量、PS寿命和AF终止或碎片整理率。1. AF维持时间（p<0.001）、DF的时空平均方差（p<0.001）和PS数量（p = 0.023）一致显示CV依赖性双峰模式（在CV 0.4 m/s时最高，在CV 0.6 m/s时最低）。2. 10%最高DF消融后，CV 0.4m/s时AF碎片化率最低（37.8%），但CV 0.5和0.6m/s时最高（均为100%，p<0.001）。3.在房颤终止或碎片整理后进行10%最高DF消融的事件中，基线房颤维持时间较短（p<0.001），DF的时空平均方差较低（p = 0.014），PS数量低于DF消融后房颤碎片整理失败的事件（p = 0.004）。DF的虚拟消融（可能指示AF驱动因素）更有可能终止或碎片化具有时空稳定DF的AF，但不太可能在持久和持续AF条件下这样做，取决于CV。
We previously reported that stable rotors are observed in in-silico human atrial fibrillation (AF) models, and are well represented by a dominant frequency (DF). In the current study, we hypothesized that the outcome of DF ablation is affected by conduction velocity (CV) conditions and examined this hypothesis using in-silico 3D-AF modeling. We integrated 3D CT images of left atrium obtained from 10 patients with persistent AF (80% male, 61.8±13.5 years old) into in-silico AF model. We compared AF maintenance durations (max 300s), spatiotemporal stabilities of DF, phase singularity (PS) number, life-span of PS, and AF termination or defragmentation rates after virtual DF ablation with 5 different CV conditions (0.2, 0.3, 0.4, 0.5, and 0.6m/s). 1. AF maintenance duration (p<0.001), spatiotemporal mean variance of DF (p<0.001), and the number of PS (p = 0.023) showed CV dependent bimodal patterns (highest at CV0.4m/s and lowest at CV0.6m/s) consistently. 2. After 10% highest DF ablation, AF defragmentation rates were the lowest at CV0.4m/s (37.8%), but highest at CV0.5 and 0.6m/s (all 100%, p<0.001). 3. In the episodes with AF termination or defragmentation followed by 10% highest DF ablation, baseline AF maintenance duration was shorter (p<0.001), spatiotemporal mean variance of DF was lower (p = 0.014), and the number of PS was lower (p = 0.004) than those with failed AF defragmentation after DF ablation. Virtual ablation of DF, which may indicate AF driver, was more likely to terminate or defragment AF with spatiotemporally stable DF, but not likely to do so in long-lasting and sustained AF conditions, depending on CV.
登录
查看更多内容
影响因子：
64.8
作者：
Gray, RA;Pertsov, AM;Jalife, J
通讯作者：
Jalife, J
影响因子：
15.9
作者：
Kim, YH;Garfinkel, A;Chen, PS
通讯作者：
Chen, PS
影响因子：
6.1
作者：
Labarthe, Simon;Bayer, Jason;Vigmond, Edward
通讯作者：
Vigmond, Edward
影响因子：
56.9
作者：
GRAY, RA;JALIFE, J;PERTSOV, AM
通讯作者：
PERTSOV, AM
影响因子：
5.5
作者：
Girmatsion, Zenawit;Biliczki, Peter;Ehrlich, Joachim R.
通讯作者：
Ehrlich, Joachim R.