Med Biol Eng Comput - In-silico modeling of atrial repolarization in normal and atrial fibrillation remodeled state.

Tópicos

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Resumo

Atrial fibrillation (AF) is the most common cardiac arrhythmia, and the total number of AF patients is constantly increasing. The mechanisms leading to and sustaining AF are not completely understood yet. Heterogeneities in atrial electrophysiology seem to play an important role in this context. Although some heterogeneities have been used in in-silico human atrial modeling studies, they have not been thoroughly investigated. In this study, the original electrophysiological (EP) models of Courtemanche et?al., Nygren et?al. and Maleckar et?al. were adjusted to reproduce action potentials in 13 atrial regions. The parameter sets were validated against experimental action potential duration data and ECG data from patients with AV block. The use of the heterogeneous EP model led to a more synchronized repolarization sequence in a variety of 3D atrial anatomical models. Combination of the heterogeneous EP model with a model of persistent AF-remodeled electrophysiology led to a drastic change in cell electrophysiology. Simulated Ta-waves were significantly shorter under the remodeling. The heterogeneities in cell electrophysiology explain the previously observed Ta-wave effects. The results mark an important step toward the reliable simulation of the atrial repolarization sequence, give a deeper understanding of the mechanism of atrial repolarization and enable further clinical investigations.

Resumo Limpo

atrial fibril af common cardiac arrhythmia total number af patient constant increas mechan lead sustain af complet understood yet heterogen atrial electrophysiolog seem play import role context although heterogen use insilico human atrial model studi thorough investig studi origin electrophysiolog ep model courtemanch etal nygren etal maleckar etal adjust reproduc action potenti atrial region paramet set valid experiment action potenti durat data ecg data patient av block use heterogen ep model led synchron repolar sequenc varieti d atrial anatom model combin heterogen ep model model persist afremodel electrophysiolog led drastic chang cell electrophysiolog simul tawav signific shorter remodel heterogen cell electrophysiolog explain previous observ tawav effect result mark import step toward reliabl simul atrial repolar sequenc give deeper understand mechan atrial repolar enabl clinic investig

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