Estimating the time scale and anatomical location of atrial fibrillation spontaneous termination in a biophysical model

• Published in: Medical & biological engineering & computing Vol. 50; no. 2; pp. 155 - 163
• Main Authors: Uldry, Laurent, Jacquemet, Vincent, Virag, Nathalie, Kappenberger, Lukas, Vesin, Jean-Marc
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.02.2012; Springer Nature B.V
• Subjects: Atrial Fibrillation - pathology; Atrial Fibrillation - physiopathology; Biomedical and Life Sciences; Biomedical engineering; Biomedical Engineering and Bioengineering; Biomedicine; Biophysics; Cardiac arrhythmia; Computer Applications; Computer Simulation; Coronary vessels; Electrocardiography - methods; Geometry; Heart Atria - physiopathology; Human Physiology; Humans; Hypotheses; Imaging; Medical research; Models, Cardiovascular; Original Article; Propagation; Radiology; Signal Processing, Computer-Assisted; Simulation; Studies; Time Factors; Biophysical modeling; Spontaneous termination; Atrial fibrillation
• ISSN: 0140-0118; 1741-0444
• DOI: 10.1007/s11517-011-0859-3

Due to their transient nature, spontaneous terminations of atrial fibrillation (AF) are difficult to investigate. Apparently, confounding experimental findings about the time scale of this phenomenon have been reported, with values ranging from 1 s to 1 min. We propose a biophysical modeling approach to study the mechanisms of spontaneous termination in two models of AF with different levels of dynamical complexity. 8 s preceding spontaneous terminations were studied and the evolution of cycle length and wavefront propagation were documented to assess the time scale and anatomical location of the phenomenon. Results suggest that termination mechanisms are dependent on the underlying complexity of AF. During simulated AF of low complexity, the total process of spontaneous termination lasted 3,200 ms and was triggered in the left atrium 800 ms earlier than in the right atrium. The last fibrillatory activity was observed more often in the right atrium. These asymmetric termination mechanisms in both time and space were not observed during spontaneous terminations of complex AF simulations, which showed less predictable termination patterns lasting only 1,600 ms. This study contributes to the interpretation of previous clinical observations, and illustrates how computer modeling provides a complementary approach to study the mechanisms of cardiac arrhythmias.