Left atrial wall stress distribution and its relationship to electrophysiologic remodeling in persistent atrial fibrillation

Journal article


Hunter, R. J., Liu, Yankai, Lu, Yiling, Wang, Wen and Schilling, R. J. 2012. Left atrial wall stress distribution and its relationship to electrophysiologic remodeling in persistent atrial fibrillation. Circulation: Arrhythmia and Electrophysiology. https://doi.org/10.1161/CIRCEP.111.965541
AuthorsHunter, R. J., Liu, Yankai, Lu, Yiling, Wang, Wen and Schilling, R. J.
Abstract

Background—Atrial stretch causes remodeling that predisposes to atrial fibrillation. We tested the hypothesis that peaks in left atrial (LA) wall stress are associated with focal remodeling. Methods and Results—Nineteen patients underwent LA mapping before catheter ablation for persistent atrial fibrillation. Finite Element Analysis was used to predict wall stress distribution based on LA geometry from CT. The relationship was assessed between wall stress and (1) electrogram voltage and (2) complex fractionated atrial electrograms (CFAE), using CFAE mean (the mean interval between deflections). Wall stress varied widely within atria and between subjects (median, 36 kPa; interquartile range, 26–51 kP). Peaks in wall stress (≥90th percentile) were common at the pulmonary vein (PV) ostia (93%), the appendage ridge (100%), the high posterior wall (84%), and the anterior wall and septal regions (42–84%). Electrogram voltage showed an inverse relationship across quartiles for wall stress (19% difference across quartiles, P=0.016). There was no effect on CFAE mean across quartiles of wall stress. Receiver operating characteristic analysis showed high wall stress was associated with low voltage (ie, <0.5 mV) and electrical scar (ie, <0.05 mV; both P<0.0001) and with absence of CFAE (ie, CFAE mean <120 ms; P<0.0001). However, peaks in wall stress and CFAE were found at 88% of PV ostia. Conclusions—Peaks in wall stress were associated with areas of low voltage, suggestive of focal remodeling. Although peaks in wall stress were not associated with LA CFAE, the PV ostia may respond differently.

Background—Atrial stretch causes remodeling that predisposes to atrial fibrillation. We tested the hypothesis that peaks in left atrial (LA) wall stress are associated with focal remodeling.

Methods and Results—Nineteen patients underwent LA mapping before catheter ablation for persistent atrial fibrillation. Finite Element Analysis was used to predict wall stress distribution based on LA geometry from CT. The relationship was assessed between wall stress and (1) electrogram voltage and (2) complex fractionated atrial electrograms (CFAE), using CFAE mean (the mean interval between deflections). Wall stress varied widely within atria and between subjects (median, 36 kPa; interquartile range, 26–51 kP). Peaks in wall stress (≥90th percentile) were common at the pulmonary vein (PV) ostia (93%), the appendage ridge (100%), the high posterior wall (84%), and the anterior wall and septal regions (42–84%). Electrogram voltage showed an inverse relationship across quartiles for wall stress (19% difference across quartiles, P=0.016). There was no effect on CFAE mean across quartiles of wall stress. Receiver operating characteristic analysis showed high wall stress was associated with low voltage (ie, <0.5 mV) and electrical scar (ie, <0.05 mV; both P<0.0001) and with absence of CFAE (ie, CFAE mean <120 ms; P<0.0001). However, peaks in wall stress and CFAE were found at 88% of PV ostia.

Conclusions—Peaks in wall stress were associated with areas of low voltage, suggestive of focal remodeling. Although peaks in wall stress were not associated with LA CFAE, the PV ostia may respond differently.

KeywordsAtrial fibrillation; Computional modeling; Wall stresss; Complex fractionated atrial electrogram
Year2012
JournalCirculation: Arrhythmia and Electrophysiology
ISSN1941-3149
1941-3084
Digital Object Identifier (DOI)https://doi.org/10.1161/CIRCEP.111.965541
Web address (URL)http://hdl.handle.net/10545/313858
hdl:10545/313858
Publication datesJan 2012
Publication process dates
Deposited10 Mar 2014, 16:13
Rights

Archived with thanks to Circulation: Arrhythmia and Electrophysiology

ContributorsUniversity of Derby
File
File Access Level
Open
Permalink -

https://repository.derby.ac.uk/item/95001/left-atrial-wall-stress-distribution-and-its-relationship-to-electrophysiologic-remodeling-in-persistent-atrial-fibrillation

Download files

  • 18
    total views
  • 0
    total downloads
  • 0
    views this month
  • 0
    downloads this month

Export as

Related outputs

Long Sump Life Effects of a Naturally Aged Bio-Ester Oil Emulsion on Tool Wear in Finish Turning a Ni-Based Superalloy
Paul Wood, Andrew Mantle, Fathi Boud, Carter, W., Gunputh, U., Pawlik, M., Lu, Y., José Díaz-Álvarez and María Henar Miguélez Garrido Long Sump Life Effects of a Naturally Aged Bio-Ester Oil Emulsion on Tool Wear in Finish Turning a Ni-Based Superalloy. Metals. https://doi.org/10.3390/met13091610
Effect of Powder Bed Fusion Laser Sintering on Dimensional Accuracy and Tensile Properties of Reused Polyamide 11
Gunputh, U., Williams, G., Pawlik, M., Lu, Y. and Wood, P. 2023. Effect of Powder Bed Fusion Laser Sintering on Dimensional Accuracy and Tensile Properties of Reused Polyamide 11. Polymers. https://doi.org/10.3390/polym15234602
Effect of Grain Structure on Machinability of LPBF Inconel 718: A Critical Review
Hama, J., Gunputh, U., Lu, Y., Wood, P. and Alvarez, J. 2023. Effect of Grain Structure on Machinability of LPBF Inconel 718: A Critical Review. 20th International Conference on Manufacturing Research, Incorporating the 37th National Conference on Manufacturing Research. IOS Press. https://doi.org/10.3233/ATDE230896
Characterisation of impact resistance of composite reinforced by hybridised carbon-flax fibres in polyfurfuryl alcohol resin
Lu, Y., Pawlik, M., Ganapathi, S. P., Wood, P., Gunputh, U. and Le, H. 2023. Characterisation of impact resistance of composite reinforced by hybridised carbon-flax fibres in polyfurfuryl alcohol resin. The 2nd International Conference on Mechanical Automation and Engineering Materials (MAEM 2023) . IOP Publishing. https://doi.org/10.1088/1742-6596/2612/1/012013
Prediction of carbon nanotubes reinforced interphase properties in fuzzy fibre reinforced polymer via inverse analysis and optimisation
Pawlik, M., Le, H., Wood, P. and Lu, Y. 2023. Prediction of carbon nanotubes reinforced interphase properties in fuzzy fibre reinforced polymer via inverse analysis and optimisation. Computational Material Science. 231, pp. 1-11. https://doi.org/10.1016/j.commatsci.2023.112548
Microstructure Effects on the Machinability of AM-Produced Superalloys
Wood, P., Díaz-Álvarez, J., Lu, Y., Rusinek, A., Gunputh, U., Bahi, S., Díaz-Álvarez, A., Miguélez, M. H., Lu, Y., Platek, P. and Sienkiewicz, J. 2023. Microstructure Effects on the Machinability of AM-Produced Superalloys. Crystals. 13 (8), pp. 1-16. https://doi.org/10.3390/cryst13081190
Creep-Fatigue Behaviours of Sn-Ag-Cu Solder Joints in Microelectronics Applications
Depiver, Joshua Adeniyi, Sabuj, Mallik, Amalu, Emeka H and Lu, Yiling 2021. Creep-Fatigue Behaviours of Sn-Ag-Cu Solder Joints in Microelectronics Applications. Production and Manufacturing Research.
Design and Manufacture of One-Size-Fits-All Healthcare Face Shields for the NHS During the COVID-19 Pandemic
Gunputh, U., Williams, G., Leighton, A., Carter, W., Varasteh, H., Pawlik, M., Lu, Y., Sims, R., Lyons, M., Clementson, J., Tripathi, G., Nick Chambers, Matt Roe and Wood, P. 2022. Design and Manufacture of One-Size-Fits-All Healthcare Face Shields for the NHS During the COVID-19 Pandemic. SSRN Electronic Journal. https://doi.org/10.2139/ssrn.4258668
On the Lubricity and Comparative Life Cycle of Biobased Synthetic and Mineral Oil Emulsions in Machining Titanium Ti-6Al-4V at Low Cutting Speed
Wood, P., Boud, F., Carter, W., Varasteh, H., Gunputh, U., Pawlik, M., Clementson, J., Lu, Y. and Hossain, S. 2022. On the Lubricity and Comparative Life Cycle of Biobased Synthetic and Mineral Oil Emulsions in Machining Titanium Ti-6Al-4V at Low Cutting Speed. Journal of Manufacturing and material processing. 6 (6), pp. 1-16. https://doi.org/10.3390/jmmp6060154
Surface engineering of carbon fibre/epoxy composites with woven steel mesh for adhesion strength enhancement
Pawlik, M., Cheah, L.Y.Y, Gunputh, U., Le, H., Wood, P. and Lu, Y. 2022. Surface engineering of carbon fibre/epoxy composites with woven steel mesh for adhesion strength enhancement. International Journal of Adhesion and Adhesives. 114, pp. 1-8. https://doi.org/10.1016/j.ijadhadh.2022.103105
Effects of surface modification and graphene nanoplatelet reinforcement on adhesive joint of aluminium alloys
Pawlik, Marzena, Lu, Yiling and Le, Huirong 2020. Effects of surface modification and graphene nanoplatelet reinforcement on adhesive joint of aluminium alloys. International Journal of Adhesion and Adhesives. https://doi.org/10.1016/j.ijadhadh.2020.102591
Numerical analysis of flow in the gap of a simplified tractor-trailer model with cross vortex trap device
charles, terrance, Yang, Zhiyin and Lu, Yiling 2019. Numerical analysis of flow in the gap of a simplified tractor-trailer model with cross vortex trap device. International Journal of Mechanical and Mechatronics Engineering. https://doi.org/10.5281/zenodo.3593100
Effects of the graphene nanoplatelets reinforced interphase on mechanical properties of carbon fibre reinforced polymer – A multiscale modelling study
Le, Huirong, Lu, Yiling, Pawlik, Marzena and Marzena, Pawlik 2019. Effects of the graphene nanoplatelets reinforced interphase on mechanical properties of carbon fibre reinforced polymer – A multiscale modelling study. Composites Part B: Engineering. 177, p. 107097. https://doi.org/10.1016/j.compositesb.2019.107097
Multiscale modelling of fluid and solute transport in soft tissues and microvessels
Lu, Yiling and Wang, Wen 2010. Multiscale modelling of fluid and solute transport in soft tissues and microvessels. Journal of Multiscale Modelling. https://doi.org/10.1142/S175697371000028X
Inert gas clearance from tissue by co-currently and counter-currently arranged microvessels
Lu, Yiling, Michel, C. C. and Wang, Wen 2012. Inert gas clearance from tissue by co-currently and counter-currently arranged microvessels. Journal of Applied Physiology. https://doi.org/10.1152/japplphysiol.00006.2012