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. 2012 Nov-Dec;45(6):640-5.
doi: 10.1016/j.jelectrocard.2012.08.005. Epub 2012 Sep 19.

Methodology for patient-specific modeling of atrial fibrosis as a substrate for atrial fibrillation

Kathleen S McDowell  1 , Fijoy Vadakkumpadan, Robert Blake, Joshua Blauer, Gernot Plank, Rob S MacLeod, Natalia A Trayanova
Affiliations

Methodology for patient-specific modeling of atrial fibrosis as a substrate for atrial fibrillation

Kathleen S McDowell et al. J Electrocardiol. 2012 Nov-Dec.

Abstract

Personalized computational cardiac models are emerging as an important tool for studying cardiac arrhythmia mechanisms, and have the potential to become powerful instruments for guiding clinical anti-arrhythmia therapy. In this article, we present the methodology for constructing a patient-specific model of atrial fibrosis as a substrate for atrial fibrillation. The model is constructed from high-resolution late gadolinium-enhanced magnetic resonance imaging (LGE-MRI) images acquired in vivo from a patient suffering from persistent atrial fibrillation, accurately capturing both the patient's atrial geometry and the distribution of the fibrotic regions in the atria. Atrial fiber orientation is estimated using a novel image-based method, and fibrosis is represented in the patient-specific fibrotic regions as incorporating collagenous septa, gap junction remodeling, and myofibroblast proliferation. A proof-of-concept simulation result of reentrant circuits underlying atrial fibrillation in the model of the patient's fibrotic atrium is presented to demonstrate the completion of methodology development.

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Figures

Fig. 1
Fig. 1
Model generation. Representative MRI slice of the human heart, segmentation of atrial slice, and 3D atrial model.
Fig. 2
Fig. 2
(A) Corresponding anatomical landmarks (yellow dots) on the atlas and patient image stacks. (B). Estimation of patient geometry fiber orientation.
Fig. 3
Fig. 3
Transmembrane potential maps of arrhythmia at four time instants in the patient-specific LA model following pulmonary vein ectopy. Red arrow indicates the location of the ectopic beat. Conduction direction is indicated by the black arrows. Scar anatomy (red) is depicted at right.
See this image and copyright information in PMC

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