Identifying locations susceptible to micro-anatomical reentry using a spatial network representation of atrial fibre maps
File(s)journal.pone.0267166.pdf (3.03 MB)
Published version
Author(s)
Type
Journal Article
Abstract
Micro-anatomical reentry has been identified as a potential driver of atrial fibrillation (AF). In this paper, we introduce a novel computational method which aims to identify which atrial regions are most susceptible to micro-reentry. The approach, which considers the structural basis for micro-reentry only, is based on the premise that the accumulation of electrically insulating interstitial fibrosis can be modelled by simulating percolation-like phenomena on spatial networks. Our results suggest that at high coupling, where micro-reentry is rare, the micro-reentrant substrate is highly clustered
in areas where the atrial walls are thin and have convex wall morphology, likely facilitating localised treatment via ablation. However, as transverse connections between fibres are removed, mimicking the accumulation of interstitial fibrosis, the substrate becomes less spatially clustered, and the bias to forming in thin, convex regions of the atria is reduced, possibly restricting the efficacy of localised ablation. Comparing our algorithm on image-based models with and without atrial fibre structure, we find that
strong longitudinal fibre coupling can suppress the micro-reentrant substrate, whereas regions with disordered fibre orientations have an enhanced risk of micro-reentry. With further development, these methods may be useful for modelling the temporal development of the fibrotic substrate on an individualised basis.
in areas where the atrial walls are thin and have convex wall morphology, likely facilitating localised treatment via ablation. However, as transverse connections between fibres are removed, mimicking the accumulation of interstitial fibrosis, the substrate becomes less spatially clustered, and the bias to forming in thin, convex regions of the atria is reduced, possibly restricting the efficacy of localised ablation. Comparing our algorithm on image-based models with and without atrial fibre structure, we find that
strong longitudinal fibre coupling can suppress the micro-reentrant substrate, whereas regions with disordered fibre orientations have an enhanced risk of micro-reentry. With further development, these methods may be useful for modelling the temporal development of the fibrotic substrate on an individualised basis.
Date Issued
2022-06-23
Date Acceptance
2022-04-03
Citation
PLoS One, 2022, 17 (6), pp.1-24
ISSN
1932-6203
Publisher
Public Library of Science (PLoS)
Start Page
1
End Page
24
Journal / Book Title
PLoS One
Volume
17
Issue
6
Copyright Statement
© 2022 Falkenberg et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
License URL
Sponsor
Engineering and Physical Sciences Research Council
British Heart Foundation
Identifier
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0267166
Grant Number
EP/N509486/1
RG/16/3/32175
Subjects
Atrial Fibrillation
Catheter Ablation
Fibrosis
Heart Atria
Humans
Heart Atria
Humans
Atrial Fibrillation
Fibrosis
Catheter Ablation
General Science & Technology
Publication Status
Published
Date Publish Online
2022-06-23