Computational Modelling of Electro-Mechanical Coupling in the Atria and Its Changes During Atrial Fibrillation

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Abstract

Atrial fibrillation (AF) is a very common, multifaceted disease that affects atrial structure as well as electrophysiological and biomechanical function. However, the mechanistic links between structural and functional factors underlying AF are poorly understood. To explore these mechanisms, a 3D atrial electro-mechanical (EM) model was developed that includes 3D atrial geometry based on the Visible Female dataset, rule-based fibre orientation, CRN human atrial electrophysiology model and activation-based mechanical contraction model. Electrical activation in the 3D atria was simulated under control condition and two AF scenarios: sinus rhythm (SR), functional re-entry in the right atrium (RA) and structural re-entry around fibrotic patches in the left atrium (LA). Fibrosis distributions were obtained from patient LGE MRI data. In both AF scenarios, re-entrant behaviours led to substantial reductions in the displacement at peak contraction compared to SR. Specifically, high-frequency re-entry led to a decrease in maximal displacement from 6.8 to 6.1 mm in the posterior RA, and a larger decrease from 7.8 to 4.5 mm in the LA in the presence of fibrotic patches. The simulated displacement values agreed with available clinical data. In conclusion, the novel model of EM coupling in the 3D human atria provided new insights into the mechanistic links between atrial electrics and mechanics during normal activation and re-entry sustaining AF. Re-entry in the RA and LA resulted in weaker contractions compared to SR, with additional effect of fibrosis on the atrial wall stiffness further reducing the contraction.

Original languageEnglish
Title of host publication Lecture Notes in Computer Science
Subtitle of host publicationInternational Workshop on Statistical Atlases and Computational Models of the Heart 2018
EditorsJichao Zhao, Maxime Sermesant, Alistair Young, Kawal Rhode, Shuo Li, Kristin McLeod, Mihaela Pop, Tommaso Mansi
PublisherSpringer‐Verlag Berlin Heidelberg
Pages103-113
Number of pages10
Volume11395
ISBN (Electronic)978-3-030-12029-0
ISBN (Print)978-3-030-12028-3
DOIs
Publication statusPublished - 14 Feb 2019

Keywords

  • Atrial fibrillation
  • Electro-mechanical coupling
  • Fibrosis
  • Mechanical contraction
  • Re-entry
  • Sinus rhythm

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