Use of a biophysical model of atrial fibrillation in the interpretation of the outcome of surgical ablation procedures
Détails
Etat: Public
Version: Final published version
Licence: Non spécifiée
It was possible to publish this article open access thanks to a Swiss National Licence with the publisher.
ID Serval
serval:BIB_FADCFBC46D36
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Use of a biophysical model of atrial fibrillation in the interpretation of the outcome of surgical ablation procedures
Périodique
European Journal of Cardio-Thoracic Surgery
ISSN
1010-7940 (Print)
Statut éditorial
Publié
Date de publication
07/2007
Volume
32
Numéro
1
Pages
90-5
Notes
Journal Article
Research Support, Non-U.S. Gov't
Validation Studies --- Old month value: Jul
Research Support, Non-U.S. Gov't
Validation Studies --- Old month value: Jul
Résumé
OBJECTIVE: To determine the adequacy of 'in silico' biophysical models of atrial fibrillation (AF) in the design of different ablation line patterns. BACKGROUND: Permanent AF is a severe medical problem for which (surgical) ablation is a possible treatment. The ideal ablation pattern remains to be defined. METHODS: Forty-six consecutive adult patients with symptomatic permanent drug refractory AF underwent mitral surgery combined with non-transmural, (n=20) and transmural (n=26) radiofrequency Minimaze. The fraction of 'in vivo' conversions to sinus rhythm (SR) in both groups was compared with the performance of the fraction of 'in silico' conversions observed in a biophysical model of permanent AF. The simulations allowed us to study the effectiveness of incomplete and complete ablation patterns. A simulated, complete, transmural Maze III ablation pattern was applied to 118 different episodes of simulated AF set-up in the model and its effectiveness was compared with the clinical results reported by Cox. RESULTS: The fraction of conversions to SR was 92% 'in vivo' and 88% 'in silico' (p=ns) for transmural/complete ablations, 60% respectively 65% for non-transmural/incomplete Minimaze (p=ns) and 98% respectively 100% for Maze III ablations (p=ns). The fraction of conversions to SR 'in silico' correlated with the rates 'in vivo' (r2=0.973). CONCLUSIONS: The fraction of conversions to SR observed in the model closely corresponded to the conversion rate to SR post-surgery. This suggests that the model provides an additional, non-invasive tool for optimizing ablation line patterns for treating permanent AF.
Mots-clé
Aged
Atrial Fibrillation/pathology/*surgery
Catheter Ablation/*methods
Female
Heart Atria/pathology/surgery
Humans
Magnetic Resonance Imaging
Male
Middle Aged
*Models, Cardiovascular
Treatment Outcome
Pubmed
Web of science
Open Access
Oui
Création de la notice
28/01/2008 11:09
Dernière modification de la notice
14/02/2022 8:57