Arrhythmias & electrophysiology
Comparing Inducibility of Re-Entrant Arrhythmia in Patient-Specific Computational Models to Clinical Atrial Fibrillation Phenotypes
Authors' conclusion
Simulations in persistent AF models show a 41% relative improvement in model/clinical agreement when ϴ is modulated.
Study context
- Population
- Patients with persistent atrial fibrillation (AF) undergoing ablation, followed ≥2 years74 left atrial (LA) models
- Participants
- 37 patients
- Comparison
- Modulated conduction velocity vs baseline ϴ in persistent AF models
- Outcome
- Model/clinical agreement of in silico arrhythmia inducibility with clinical post-ablation outcome:
- AF
- AFL
- No recurrence
Methodological detailspatient-specific LA models from pre- and post-ablation MRI
- Patient-specific LA models from pre- and post-ablation MRI
Main finding
As reported in the abstract
Model/clinical agreement
P = 0.014
Further findings
Clinical recurrence · ≥2 years
- Recurrence with AF
- 15 (41%)
- Recurrence with atrial flutter (AFL)
- 6 (16%)
Arrhythmia induction in simulations
- Simulations with induced arrhythmia
- 1,078 of 5,550
Agreement in pre- and post-ablation models
- ϴ modulation improved agreement in both pre-ablation and post-ablation models
Pre-ablation agreement by LA fibrosis and BMI (subgroups)
- Significantly greater agreement with extensive LA fibrosis
- >17.2%
- Significantly greater agreement with elevated BMI
- >32.0 kg/m²
Original publication
Comparing Inducibility of Re-Entrant Arrhythmia in Patient-Specific Computational Models to Clinical Atrial Fibrillation Phenotypes. JACC Clin Electrophysiol. Published 30 August 2023. doi:10.
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