Boyle Patrick M, Zahid Sohail, Trayanova Natalia A
Department of Biomedical Engineering and Institute for Computational Medicine, Johns Hopkins University, 3400 N Charles St, 208 Hackerman Hall, Baltimore, MD 21218, USA.
Department of Biomedical Engineering and Institute for Computational Medicine, Johns Hopkins University, 3400 N Charles St, 208 Hackerman Hall, Baltimore, MD 21218, USA
Europace. 2016 Dec;18(suppl 4):iv136-iv145. doi: 10.1093/europace/euw358.
: Atrial arrhythmias involving a fibrotic substrate are an important cause of morbidity and mortality. In many cases, effective treatment of such rhythm disorders is severely hindered by a lack of mechanistic understanding relating features of fibrotic remodelling to dynamics of re-entrant arrhythmia. With the advent of clinical imaging modalities capable of resolving the unique fibrosis spatial pattern present in the atria of each individual patient, a promising new research trajectory has emerged in which personalized computational models are used to analyse mechanistic underpinnings of arrhythmia dynamics based on the distribution of fibrotic tissue. In this review, we first present findings that have yielded a robust and detailed biophysical representation of fibrotic substrate electrophysiological properties. Then, we summarize the results of several recent investigations seeking to use organ-scale models of the fibrotic human atria to derive new insights on mechanisms of arrhythmia perpetuation and to develop novel strategies for model-assisted individualized planning of catheter ablation procedures for atrial arrhythmias.
涉及纤维化基质的房性心律失常是发病和死亡的重要原因。在许多情况下，由于缺乏将纤维化重塑特征与折返性心律失常动态联系起来的机制理解，此类节律紊乱的有效治疗受到严重阻碍。随着能够解析每个患者心房中独特纤维化空间模式的临床成像模式的出现，出现了一条有前景的新研究轨迹，即使用个性化计算模型基于纤维化组织的分布来分析心律失常动态的机制基础。在本综述中，我们首先展示了一些研究结果，这些结果产生了对纤维化基质电生理特性的强大而详细的生物物理表征。然后，我们总结了最近几项研究的结果，这些研究试图使用纤维化人类心房的器官尺度模型来获得关于心律失常持续机制的新见解，并为房性心律失常的导管消融手术开发模型辅助个体化规划的新策略。
