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A Reproducible Protocol to Assess Arrhythmia Vulnerability in silico: Pacing at the End of the Effective Refractory Period

Azzolin, Luca; Schuler, Steffen; Dössel, Olaf; Loewe, Axel

Abstract:
In both clinical and computational studies, different pacing protocols are used to induce arrhythmia and non-inducibility is often considered as the endpoint of treatment. The need for a standardized methodology is urgent since the choice of the protocol used to induce arrhythmia could lead to contrasting results, e.g., in assessing atrial fibrillation (AF) vulnerabilty. Therefore, we propose a novel method—pacing at the end of the effective refractory period (PEERP)—and compare it to state-of-the-art protocols, such as phase singularity distribution (PSD) and rapid pacing (RP) in a computational study. All methods were tested by pacing from evenly distributed endocardial points at 1 cm inter-point distance in two bi-atrial geometries. Seven different atrial models were implemented: five cases without specific AF-induced remodeling but with decreasing global conduction velocity and two persistent AF cases with an increasing amount of fibrosis resembling different substrate remodeling stages. Compared with PSD and RP, PEERP induced a larger variety of arrhythmia complexity requiring, on average, only 2.7 extra-stimuli and 3 s of simulation time to initiate reentry. ... mehr

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Verlagsausgabe §
DOI: 10.5445/IR/1000131897
Veröffentlicht am 27.04.2021
Originalveröffentlichung
DOI: 10.3389/fphys.2021.656411
Cover der Publikation
Zugehörige Institution(en) am KIT Institut für Biomedizinische Technik (IBT)
Publikationstyp Zeitschriftenaufsatz
Publikationsjahr 2021
Sprache Englisch
Identifikator ISSN: 1664-042X
KITopen-ID: 1000131897
Erschienen in Frontiers in physiology
Verlag Frontiers Media
Band 12
Seiten Art.-Nr.: 656411
Vorab online veröffentlicht am 01.04.2021
Schlagwörter arrhythmia, atrial fibrillation, computational modeling, pacing protocol, reproducibility, vulnerability
Nachgewiesen in Scopus
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