Stability of scroll excitation waves in human atria during fibrillation: A computational study

We computationally evaluated the functional roles of atrial fibrillation induced electrical remodelling (AFER) on human atrial electrical excitations at cellular, tissue and whole organ levels. Our results show that AFER produced a dramatic reduction in action potential duration, slowing down of intra-atrial conduction, decrease in tissuepsilas temporal vulnerability, but remarkable increase in tissuepsilas spatial vulnerability to arrythmogenesis in response to premature stimulus. It also increased stability of re-entrant waves in 2D and 3D models. With AFER, the rate of atrial excitation was much higher and re-entry degenerated into persistent spatio-temporal chaos. In conclusion, our simulations substantiate a link between AFER and persistence of AF. This study provided a mechanistic insight into the mechanisms underlying the perpetuation and maintenance of AF.