Modélisation de l’activité électrique des oreillettes avant et après ablation par cathéter
Atrial fibrillation (AF) is the most common form of arrhythmia in humans. The mechanisms governing the initiation and manifestations of that disease are complex, dynamic in nature, including interactions across multiple spatial and temporal scales in the atria. This often leads to unpredictable manifestations and phenomena that arise at the level of the organ, and are reflected across the entire torso. To remedy that problem, catheter ablation can be carried out, which consists in creating linear lesions which block and force the electrical propagation in the atrial tissue. Sometimes these lines reconnect after the procedure, which leads to atrial fibrillation recurrence, thus requiring a new intervention. The purpose of this work is to model the monitoring of the postoperative P wave to detect non-invasively the reconnection of ablation lines and to predict atrial fibrillation recurrences. Using a mathematical model of the atria and thorax, the P waves are simulated before and after ablation, as well as after reconnection of some ablation lines. The results show that the morphology and the characteristics of the P wave as well as the activation map are significantly affected by the ablation lines and the subsequent reconnections. These differences are more easily detected when reconnections arise on the left inferior pulmonary vein. The changes are most important in electrodes placed in certain areas of the torso, notably in the back. These new data are helping to plan a clinical study to validate the approach.
Atrial fibrillation Mathematical modeling Catheter ablation Ablation lines reconnection P wave Electrocardiogram