Numerical Study of Atrial Fibrillation Effects on Flow Distribution in Aortic Circulation

• Published in: Annals of biomedical engineering Vol. 48; no. 4; pp. 1291 - 1308
• Main Authors: Deyranlou, Amin, Naish, Josephine H., Miller, Christopher A., Revell, Alistair, Keshmiri, Amir
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.04.2020; Springer Nature B.V
• Subjects: Aneurysms; Aorta; Aorta - physiopathology; Aortic arch; Arrhythmia; Arteries; Atherogenesis; Atria; Atrial Fibrillation - physiopathology; Atrial Remodeling; Atrium; Audio frequencies; Biochemistry; Biological and Medical Physics; Biomedical and Life Sciences; Biomedical Engineering and Bioengineering; Biomedicine; Biophysics; Blood clots; CAD; Cardiac arrhythmia; Carotid arteries; Carotid artery; Cell activation; Classical Mechanics; Computer aided design; Computer Simulation; Coronary Circulation; Coronary vessels; Electrocardiography; Embolism; Endothelial cells; Fibrillation; Flow distribution; Flow velocity; Heart; Models, Cardiovascular; Original; Original Article; Perfusion; Stroke; Thorax; Thrombosis; Ventricle; Ventricular Function, Left; Aorta; Computational fluid dynamics; Atrial fibrillation; 4D phase contrast magnetic resonance imaging
• ISSN: 0090-6964; 1573-9686; 1573-9686
• DOI: 10.1007/s10439-020-02448-6

Atrial fibrillation (AF) is the most common type of arrhythmia, which undermines cardiac function. Atrial fibrillation is a multi-facet malady and it may occur as a result of other diseases or it may trigger other problems. One of the main complications of AF is stroke due to the possibility of clot formation inside the atrium. However, the possibility of stroke occurrence due to the AF and the location from which an embolus dispatches are subject of debate. Another hypothesis about the embolus formation during AF is thrombus formation in aorta and carotid arteries, embolus detachment and its movement. To investigate the possibility of the latter postulation, the current work suggests a parametric study to quantify the sensitivity of aortic flow to four common AF traits including lack of atrial kick, atrial remodelling, left ventricle systolic dysfunction, and high frequency fibrillation. The simulation was carried out by coupling several in-house codes and ANSYS-CFX module. The results reveal that AF traits lower flow rate at left ventricular outflow tract, which in general lowers blood perfusion to systemic, cerebral and coronary circulations. Consequently, it leads to endothelial cell activation potential (ECAP) increase and variation of flow structure that both suggest predisposed areas to atherogenesis and thrombus formation in different regions in ascending aorta, aortic arch and descending thoracic aorta.