Role of atrial tissue substrate and electrical activation pattern in fractionation of atrial electrograms: a computational study

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Abstract

Complex fractionated atrial electrograms (CFAEs) are often used as a clinical marker for re-entrant drivers of atrial fibrillation. However, outcomes of clinical ablation procedures based on CFAEs are controversial and the mechanistic links between fractionation, re-entrant activity and the characteristics of the atrial substrate are not completely understood. We explore such links by simulating electrograms arising from both normal and re-entrant electrical activity in atrial tissue models. 2D and 3D tissue geometries with a range of conditions for intracellular coupling and myofiber orientation fields were studied. Electrograms were fractionated in the presence of complex atrial fiber fields and in 3D irregular geometries, due to far-field excitations. The complexity of the local electrical activity was not a strong determinant of the degree of fractionation. These results suggest that electrogram fractionation is more strongly linked to atrial substrate characteristics (including tissue geometry, fiber orientation and degree of intercelullar coupling) than to the electrical activation pattern sustaining atrial fibrillation.
Original languageEnglish
Title of host publicationAnnual International Conference of the IEEE Engineering in Medicine & Biology Society
PublisherInstitute of Electrical and Electronics Engineers ( IEEE )
Pages1587-1590
Number of pages4
Volume2014
ISBN (Print)9781424479276
DOIs
Publication statusPublished - Sept 2014
Event36th Annual International Conference of the IEEE Engineering in Medicine & Biology - Chicago, IL, United States
Duration: 26 Aug 201430 Aug 2014

Conference

Conference36th Annual International Conference of the IEEE Engineering in Medicine & Biology
Country/TerritoryUnited States
CityChicago, IL
Period26/08/201430/08/2014

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