Atrial fibrillation septal pacing: translation of modelling results.

Details

Serval ID
serval:BIB_EEC4C8BF0928
Type
Article: article from journal or magazin.
Collection
Publications
Title
Atrial fibrillation septal pacing: translation of modelling results.
Journal
Europace
Author(s)
Luca A., Kallmyer T., Virag N.
ISSN
1532-2092 (Electronic)
ISSN-L
1099-5129
Publication state
Published
Issued date
2016
Peer-reviewed
Oui
Volume
18
Number
suppl 4
Pages
iv53-iv59
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Atrial fibrillation (AF) septal pacing consists of rapid pacing from a ring of electrodes around the atrial septum, leading to local capture of both atria during AF. The present model-based study evaluated the impact of the number of stimulation electrodes in the septal ring on AF capture for different types of sustained AF dynamics.
Using a biophysical model of AF based on CT scans from an AF patient, models with different AF substrates (Cholinergic AF and Meandering Wavelets) were created by varying the atrial membrane kinetics. Rapid pacing was applied from the septum area with a ring of 1, 2, 3, 4, 6, 8, or 12 electrodes during 20 seconds at a pacing cycle lengths (PCLs) in the range 60-100% of AF cycle length (AFCL), in 4% steps. Percentage of captured tissue during rapid pacing was determined using 24 sensing electrode pairs evenly distributed on the atrial surface. Results were averaged over 10 AF simulations. For Cholinergic AF, the number of stimulation electrodes on the septal ring had no significant impact on AF capture independently of AF dynamics. For Meandering Wavelets, more electrodes were needed to achieve AF capture in the presence of complex AF.
Changes in AF substrate significantly impacted septal pacing outcomes and response to rapid AF pacing may similarly vary patient-to-patient. The number of stimulation electrodes had a lesser impact, suggesting that the design of a ring with 3-4 electrodes around the septum would be sufficient for most AF dynamics.
Keywords
Action Potentials, Atrial Fibrillation/diagnosis, Atrial Fibrillation/physiopathology, Atrial Septum/physiopathology, Cardiac Pacing, Artificial/methods, Chronic Disease, Electrocardiography, Electrophysiologic Techniques, Cardiac, Heart Rate, Humans, Kinetics, Models, Cardiovascular, Patient-Specific Modeling, Predictive Value of Tests, Signal Processing, Computer-Assisted, Tomography, X-Ray Computed, Translational Research, Biomedical, Atrial fibrillation, Computer modelling, Septal pacing, Translational research
Pubmed
Web of science
Create date
17/11/2021 16:13
Last modification date
08/12/2023 17:49
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