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Progress in Biophysics and Molecular Biology
Article . 2014 . Peer-reviewed
License: Elsevier TDM
Data sources: Crossref
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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; +2 Authors

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

Abstract

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.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.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.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.

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Keywords

Male, Patient-Specific Modeling, 610, Sensitivity and Specificity, Imaging, Heart Conduction System/physiopathology, User-Computer Interface, Imaging, Three-Dimensional, Models, Heart Conduction System, Three-Dimensional/methods, Atrial Fibrillation, Humans, Computer Simulation, Catheter Ablation*, Heart Conduction System/surgery*, Body Surface Potential Mapping, Models, Cardiovascular, Reproducibility of Results, Atrial Fibrillation/pathology, Atrial Fibrillation/surgery*, Middle Aged, Atrial fibrillation, Cardiovascular*, Computer-Assisted/methods*, Virtual ablation, Atrial Fibrillation/physiopathology*, Treatment Outcome, Heart Conduction System/pathology, Surgery, Computer-Assisted, Catheter Ablation, Feasibility Studies, Body Surface Potential Mapping/methods, Surgery, Catheter ablation, Female, Simulation

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
46
Top 10%
Top 10%
Top 10%
Green