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June 23, 2022PLoS ONEOpen Access

Spatial network model reveals atrial micro-reentry clusters in thin, convex regions with low fibrosis.

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Why the study?

Micro-anatomical reentry has been identified as a potential driver of AF, but computational methods are needed to identify which atrial regions are most susceptible to micro-reentry.

Population

Image-based models of atrial fibre maps

Comparison

Models with vs without atrial fibre structure

Design

Computational simulation study

Key result

A novel spatial network model demonstrated that micro-reentrant substrates are highly clustered in thin, convex atrial regions at low fibrosis densities, and are suppressed by strong longitudinal fibre coupling.

Authors

MFMax FalkenbergJCJames A. ColemanSDSam Dobson

Discussion

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Overview

Hypothesis-generating for region-specific ablation in fibrotic atria; leaves open clinical translation and validation in patients.

Structured PICO

P
Population
Computational models of atrial fibre maps
I
Intervention
Novel computational method simulating percolation-like phenomena on spatial networks to model interstitial fibrosis accumulation
C
Comparator
Image-based models with and without atrial fibre structure
O
Outcome
Identification of atrial regions susceptible to micro-reentry

A novel computational method demonstrates that the accumulation of interstitial fibrosis alters the spatial clustering of micro-reentrant substrates, potentially impacting the efficacy of localized ablation for atrial fibrillation.

Limitations

  • A uniform probability of conduction block is likely an unrealistic assumption.
  • Realistic conduction block behaviour is difficult to obtain in the discrete diffusion model framework.
  • The models used are not electrophysiologically realistic models of atrial fibrillation.
  • The approach is not suitable for studying the dynamics of micro-anatomical reentry.
  • Individual-specific fibrosis data was not available to modulate the distribution of spatial coupling.

Cite This Study

Falkenberg et al. (2022) studied Atrial fibrillation (n=3). Spatial network representation of atrial fibre maps (fibre model) vs. Fibre-less null model was evaluated on Identification of atrial regions susceptible to micro-reentry. A novel spatial network model demonstrated that micro-reentrant substrates are highly clustered in thin, convex atrial regions at low fibrosis densities, and are suppressed by strong longitudinal fibre coupling.

synapsesocial.com/papers/6a0ebc8125c30b2cc7f9b90ehttps://doi.org/10.1371/journal.pone.0267166
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Identifying locations susceptible to micro-anatomical reentry using a spatial network representation of atrial fibre maps2021 · 2 citations
  2. 2Modeling the functional heterogeneity and conditions for the occurrence of microreentry in procedurally created atrial fibrous tissue2023 · 8 citations
  3. 3Catheter configuration for mapping micro-anatomic reentries sustaining atrial fibrillation: A simulation study2026
  4. 4Reentry in a Morphologically Realistic Atrial Model2001 · 111 citations
  5. 5‘Trapped re-entry’ as source of acute focal atrial arrhythmias2023 · 11 citations