Towards personalized computational modelling of the fibrotic substrate for atrial arrhythmia
Towards personalized computational modelling of the fibrotic substrate for atrial arrhythmia
复制标题
DOI：
10.1093/europace/euw358
复制
发表时间：
2016-12-01
期刊：
影响因子：
6.1
通讯作者：
Trayanova, Natalia A.
中科院分区：
文献类型：
--
作者：
Boyle, Patrick M.;Zahid, Sohail;Trayanova, Natalia A.
涉及纤维化基质的房性心律失常是发病率和死亡率的重要原因。在许多情况下，由于缺乏对纤维化重塑特征与折返性心律失常动力学相关的机制理解，严重阻碍了此类心律失常的有效治疗。随着能够解析每个个体患者心房中存在的独特纤维化空间模式的临床成像模式的出现，出现了一种有前途的新研究轨迹，其中个性化计算模型用于基于纤维化组织的分布来分析心律失常动力学的机制基础。在这篇综述中，我们首先提出了一个强大的和详细的生物物理表示纤维化基板的电生理特性的研究结果。然后，我们总结了最近几项研究的结果，这些研究试图使用纤维化人类心房的器官尺度模型来获得关于心律失常永久化机制的新见解，并开发用于房性心律失常导管消融术的模型辅助个体化规划的新策略。
Atrial arrhythmias involving a fibrotic substrate are an important cause of morbidity and mortality. In many cases, effective treatment of such rhythm disorders is severely hindered by a lack of mechanistic understanding relating features of fibrotic remodelling to dynamics of re-entrant arrhythmia. With the advent of clinical imaging modalities capable of resolving the unique fibrosis spatial pattern present in the atria of each individual patient, a promising new research trajectory has emerged in which personalized computational models are used to analyse mechanistic underpinnings of arrhythmia dynamics based on the distribution of fibrotic tissue. In this review, we first present findings that have yielded a robust and detailed biophysical representation of fibrotic substrate electrophysiological properties. Then, we summarize the results of several recent investigations seeking to use organ-scale models of the fibrotic human atria to derive new insights on mechanisms of arrhythmia perpetuation and to develop novel strategies for model-assisted individualized planning of catheter ablation procedures for atrial arrhythmias.