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

• Published in: Journal of electrocardiology Vol. 45; no. 6; pp. 640 - 645
• Main Authors: McDowell, Kathleen S., Vadakkumpadan, Fijoy, Blake, Robert, Blauer, Joshua, Plank, Gernot, MacLeod, Rob S., Trayanova, Natalia A.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2012
• Subjects: Action Potentials; Atrial fibrillation; Atrial Fibrillation - pathology; Atrial Fibrillation - physiopathology; Atrial fibrosis; Cardiovascular; Computational model; Computer Simulation; Fibrosis; Heart Atria - pathology; Heart Atria - physiopathology; Heart Conduction System - physiopathology; Humans; Models, Cardiovascular; Patient-Centered Care - methods; Patient-specific modeling; Pilot Projects; Patient-specific modeling; Atrial fibrosis; Computational model; Atrial fibrillation
• ISSN: 0022-0736; 1532-8430; 1532-8430
• DOI: 10.1016/j.jelectrocard.2012.08.005

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.