0 421

Cited 27 times in

Virtual ablation for atrial fibrillation in personalized in-silico three-dimensional left atrial modeling: comparison with clinical catheter ablation

Authors
 Minki Hwang  ;  Soon-Sung Kwon  ;  Jin Wi  ;  Mijin Park  ;  Hyun-Seung Lee  ;  Jin-Seo Park  ;  Young-Seon Lee  ;  Eun Bo Shim  ;  Hui-Nam Pak 
Citation
 PROGRESS IN BIOPHYSICS & MOLECULAR BIOLOGY, Vol.116(1) : 40-47, 2014 
Journal Title
 PROGRESS IN BIOPHYSICS & MOLECULAR BIOLOGY 
ISSN
 0079-6107 
Issue Date
2014
MeSH
Atrial Fibrillation/pathology ; Atrial Fibrillation/physiopathology* ; Atrial Fibrillation/surgery* ; Body Surface Potential Mapping/methods ; Catheter Ablation* ; Computer Simulation ; Feasibility Studies ; Female ; Heart Conduction System/pathology ; Heart Conduction System/physiopathology ; Heart Conduction System/surgery* ; Humans ; Imaging, Three-Dimensional/methods ; Male ; Middle Aged ; Models, Cardiovascular* ; Patient-Specific Modeling ; Reproducibility of Results ; Sensitivity and Specificity ; Surgery, Computer-Assisted/methods* ; Treatment Outcome ; User-Computer Interface
Keywords
Atrial fibrillation ; Catheter ablation ; Simulation ; Virtual ablation
Abstract
BACKGROUND: Although catheter ablation is an effective rhythm control strategy for atrial fibrillation (AF), empirically-based ablation has a substantial recurrence rate. The purposes of this study were to develop a computational platform for patient-specific virtual AF ablation and to compare the anti-fibrillatory effects of 5 different virtual ablation protocols with empirically chosen clinical ablations. METHODS: We included 20 patients with AF (65% male, 60.1 ± 10.5 years old, 80% persistent AF [PeAF]) who had undergone empirically-based catheter ablation: circumferential pulmonary vein isolation (CPVI) for paroxysmal AF (PAF) and additional posterior box lesion (L1) and anterior line (L2) for PeAF. Using patient-specific three-dimensional left atrial (LA) geometry, we generated a finite element model and tested the AF termination rate after 5 different virtual ablations: CPVI alone, CPVI + L1, CPVI + L1,2, CPVI with complex fractionated atrial electrogram (CFAE) ablation, and CFAE ablation alone. RESULTS: 1. Virtual CPVI + L1,2 ablation showed the highest AF termination rate in overall patients (55%) and PeAF patients (n = 16, 62.5%). 2. The virtual AF maintenance duration was shortest in the case of virtual CPVI + L1,2 ablation in overall patients (2.19 ± 1.28 vs. 2.91 ± 1.04 s, p = 0.009) and in patients with PeAF (2.05 ± 1.23 vs. 2.93 ± 10.2 s, p = 0.004) compared with other protocols. CONCLUSION: Virtual AF ablation using personalized in-silico model of LA is feasible. Virtual ablation with CPVI + L1,2 shows the highest antifibrillatory effect, concordant with the empirical ablation protocol in patients with PeAF.
Full Text
http://www.sciencedirect.com/science/article/pii/S0079610714000959
DOI
10.1016/j.pbiomolbio.2014.09.006
Appears in Collections:
5. Research Institutes (연구소) > Yonsei Cardiovascular Research Institute (심혈관연구소) > 1. Journal Papers
5. Research Institutes (연구소) > Yonsei Integrative Research Institute for Cerebral & Cardiovascular Disease (뇌심혈관질환융합연구사업단) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Pak, Hui Nam(박희남) ORCID logo https://orcid.org/0000-0002-3256-3620
Wi, Jin(위진) ORCID logo https://orcid.org/0000-0003-0655-5130
Lee, Young Seon(이영선)
Hwang, Min Ki(황민기)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/138479
사서에게 알리기
  feedback

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse