Mechanisms of Complex Fractionated Electrogram-Targeted Ablation in a Model for Chronic Atrial Fibrillation

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概要

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• <B>Background:</B> We have recently demonstrated in computer simulations that electrotonic interactions between atrial myocytes and heterogeneously-distributed fibroblasts result in the genesis of complex fractionated atrial electrograms (CFAEs) during chronic atrial fibrillation (AF). However, previous research has not provided sufficient evidence that ablation targeting such fibroblast-derived CFAEs can terminate AF. <B>Methods:</B> To clarify this issue, we repeated simulations of CFAE-targeted ablation in the model of human chronic AF under heart failure, and we analyzed details of the excitation propagation until the AF was terminated by the application of CFAE-targeted ablation. <B>Results:</B> (1) Sustained spiral wave reentry, as a model of chronic AF, was found to terminate earlier as the number of ablation sites increased. (2) CFAE-targeted ablation site transiently pinned the spiral wave, preventing wave breakup by blocking the shortcut of the reentry. (3) The spiral wave drifted between ablation sites, and after a short time the spiral wave was pushed out of the CFAE area, resulting in AF termination. (4) For more effective CFAE-targeted ablation, avoiding collagen accumulation area and keeping an appropriate distance between ablation sites were required. <B>Conclusion:</B> Our findings might contribute to better understanding of the mechanisms of CFAE-targeted AF ablation.

著者

• Ashihara Takashi

  Department Of Cardiovascular And Respiratory Medicine Heart Rhythm Center Shiga University Of Medica

• Nakazawa Kazuo

  National Cardiovascular Cenfer Research Institute

• Nakazawa Yuko

  Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science

• Ozawa Tomoya

  Department Of Cardiology Shiga University Of Medical Science

• Horie Minoru

  Department Of Cardiac Physiology National Cardiovascular Center Research Institute

• Haraguchi Ryo

  National Cerebral And Cardiovascular Center Research Institute

• Ito Makoto

  Department Of Bioscience And Biotechnology Graduate School Of Bioresource And Bioenvironmental Scien

• Inada Shin

  National Cardiovascular Center Research Institute

• Inada Shin

  National Cerebral and Cardiovascular Center Research Institute

• Trayanova Natalia

  Johns Hopkins University

• Horie Minoru

  Department of Cardiovascular Medicine, Shiga University of Medical Science

• ITO Makoto

  Department of Bioresources, Faculty of Agriculture, Ehime University

• Ozawa Tomoya

  Department of Cardiovascular Medicine, Shiga University of Medical Science

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