Initiation of atrial fibrillation by interaction of pacemakers with geometrical constraints

Journal article

Authors/Editors

Einax, Mario

Research Areas

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Publication Details

Author list: Lenk C, Weber FM, Bauer M, Einax M, Maass P, Seeman G

Publisher: Elsevier

Place: LONDON

Publication year: 2015

Journal: Journal of Theoretical Biology (0022-5193)

Journal acronym: J THEOR BIOL

Volume number: 366

Start page: 13

End page: 23

Number of pages: 11

ISSN: 0022-5193

Languages: English-Great Britain (EN-GB)

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Abstract

Atrial fibrillation (AF) is the most common arrhythmia of the heart in industrialized countries. Its generation and the transitory behavior of paroxysmal AF are still not well understood. In this work we examine the interaction of two activation sources via an isthmus as possible cause for the initiation of fibrillation episodes. For this study, the electrophysiological model of Bueno-Orovio, Cherry and Fenton is adapted to atrial electrophysiology, both for physiological and electrophysiologically remodeled conditions due to AF. We show that the interaction of the pacemakers, combined with the geometrical constraints of the isthmus, can produce fibrillatory-type irregularities, which we quantify by the loss of spatial phase coherence in the transmembrane voltage. Transitions to irregular behavior occur when the frequencies of the pacemakers exceed certain thresholds, suggesting that AF episodes are initiated by frequency changes of the activating sources (sinus node, ectopic focus). (C) 2014 Elsevier Ltd. All rights reserved.

Keywords

Atrial electrophysiology, Obstacle-induced instability, Pacemaker interaction, Paroxysmal atrial fibrillation, synchronization

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