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Dynamical anchoring of distant arrhythmia sources by fibrotic regions via restructuring of the activation pattern

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Abstract
Rotors are functional reentry sources identified in clinically relevant cardiac arrhythmias, such as ventricular and atrial fibrillation. Ablation targeting rotor sites has resulted in arrhythmia termination. Recent clinical, experimental and modelling studies demonstrate that rotors are often anchored around fibrotic scars or regions with increased fibrosis. However the mechanisms leading to abundance of rotors at these locations are not clear. The current study explores the hypothesis whether fibrotic scars just serve as anchoring sites for the rotors or whether there are other active processes which drive the rotors to these fibrotic regions. Rotors were induced at different distances from fibrotic scars of various sizes and degree of fibrosis. Simulations were performed in a 2D model of human ventricular tissue and in a patient-specific model of the left ventricle of a patient with remote myocardial infarction. In both the 2D and the patient-specific model we found that without fibrotic scars, the rotors were stable at the site of their initiation. However, in the presence of a scar, rotors were eventually dynamically anchored from large distances by the fibrotic scar via a process of dynamical reorganization of the excitation pattern. This process coalesces with a change from polymorphic to monomorphic ventricular tachycardia.
Keywords
TURBULENT ELECTRICAL-ACTIVITY, ATRIAL-FIBRILLATION, VENTRICULAR-FIBRILLATION, FIBROSIS, MECHANISM, HEART, MODEL, HETEROGENEITIES, CONDUCTION, DISPERSION

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Chicago
Vandersickel, Nele, Masaya Watanabe, Qian Tao, Jan Fostier, Katja Zeppenfeld, and Alexander Panfilov. 2018. “Dynamical Anchoring of Distant Arrhythmia Sources by Fibrotic Regions via Restructuring of the Activation Pattern.” Plos Computational Biology 14 (12).
APA
Vandersickel, N., Watanabe, M., Tao, Q., Fostier, J., Zeppenfeld, K., & Panfilov, A. (2018). Dynamical anchoring of distant arrhythmia sources by fibrotic regions via restructuring of the activation pattern. PLOS COMPUTATIONAL BIOLOGY, 14(12).
Vancouver
1.
Vandersickel N, Watanabe M, Tao Q, Fostier J, Zeppenfeld K, Panfilov A. Dynamical anchoring of distant arrhythmia sources by fibrotic regions via restructuring of the activation pattern. PLOS COMPUTATIONAL BIOLOGY. 2018;14(12).
MLA
Vandersickel, Nele, Masaya Watanabe, Qian Tao, et al. “Dynamical Anchoring of Distant Arrhythmia Sources by Fibrotic Regions via Restructuring of the Activation Pattern.” PLOS COMPUTATIONAL BIOLOGY 14.12 (2018): n. pag. Print.
@article{8589299,
  abstract     = {Rotors are functional reentry sources identified in clinically relevant cardiac arrhythmias, such as ventricular and atrial fibrillation. Ablation targeting rotor sites has resulted in arrhythmia termination. Recent clinical, experimental and modelling studies demonstrate that rotors are often anchored around fibrotic scars or regions with increased fibrosis. However the mechanisms leading to abundance of rotors at these locations are not clear. The current study explores the hypothesis whether fibrotic scars just serve as anchoring sites for the rotors or whether there are other active processes which drive the rotors to these fibrotic regions. Rotors were induced at different distances from fibrotic scars of various sizes and degree of fibrosis. Simulations were performed in a 2D model of human ventricular tissue and in a patient-specific model of the left ventricle of a patient with remote myocardial infarction. In both the 2D and the patient-specific model we found that without fibrotic scars, the rotors were stable at the site of their initiation. However, in the presence of a scar, rotors were eventually dynamically anchored from large distances by the fibrotic scar via a process of dynamical reorganization of the excitation pattern. This process coalesces with a change from polymorphic to monomorphic ventricular tachycardia.},
  articleno    = {e1006637},
  author       = {Vandersickel, Nele and Watanabe, Masaya and Tao, Qian and Fostier, Jan and Zeppenfeld, Katja and Panfilov, Alexander},
  issn         = {1553-7358},
  journal      = {PLOS COMPUTATIONAL BIOLOGY},
  language     = {eng},
  number       = {12},
  pages        = {19},
  title        = {Dynamical anchoring of distant arrhythmia sources by fibrotic regions via restructuring of the activation pattern},
  url          = {http://dx.doi.org/10.1371/journal.pcbi.1006637},
  volume       = {14},
  year         = {2018},
}

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