Simulation of atrial electrophysiology and body surface potentials for normal and abnormal rhythm

Correlation between P-wave morphology and origin of atrial focal tachycardia--insights from realistic models of the human atria and torso

Atrial arrhythmias resulting from abnormally rapid focal activity in the atria may be reflected in an altered P-wave morphology (PWM) in the ECG. Although clinically important, detailed relationships between PWM and origins of atrial focal excitations have not been established. To study such relationships, we developed computational models of the human atria and torso. The model simulation results were used to evaluate an extant clinical algorithm for locating the origin of atrial focal points from the ECG. The simulations showed that the algorithm was practical and could predict the atrial focal locations with 85% accuracy. We proposed a further refinement of the algorithm to distinguish between focal locations within the large atrial bundles.

Synchronizing computer simulations with measurement data for a case of atrial flutter

Atrial flutter is a common supraventricular tachycardia that can be treated using radiofrequency catheter ablation, a procedure that is guided by electroanatomical mapping systems. In this paper, we propose an algorithm for incorporating mapping data into computer simulations of atrial electrical activity with the purpose of creating a more accurate map of electrical activation. The algorithm takes as input the extracellular potential values recorded at a number of sites throughout the atria and estimates the activation time for the entire atrial domain. We test the algorithm using synthetic mapping data and an anatomically detailed atrial geometry with an activation pattern typical of atrial flutter. The results show that the algorithm performs well with synthetic mapping data with information from relatively few mapping sites and in the presence of modeling and measurement error.