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Area of Science:

  • Computational electrophysiology
  • Cardiac electrophysiology
  • Medical physics

Background:

  • Persistent atrial fibrillation (AF) is driven by cardiac rotors.
  • Current ablation strategies lack precise rotor localization, limiting efficacy.
  • Improved targeting of arrhythmogenic sources is crucial for AF ablation success.

Purpose of the Study:

  • To investigate the potential of spatial temperature gradients (STGs) for cardiac rotor characterization and attraction.
  • To test the hypothesis that STGs induce spatial heterogeneity in excitability, guiding rotor movement.
  • To provide a proof-of-concept for a novel AF ablation targeting technique.

Main Methods:

  • Numerical simulations in single-cell and 2D atrial models with AF-remodelled kinetics.
  • Application of linear and local spatial temperature gradients.
  • Adjustment of ion channel kinetics using the Arrhenius equation.

Main Results:

  • Decreased temperature exponentially increased recovery time in AF-remodelled single cells.
  • Spiral waves (simulating rotors) exhibited temperature gradient-dependent drift.
  • Spiral waves were attracted to colder regions with reduced excitability.
  • A local temperature perturbation of 28°C showed optimal rotor attraction.

Conclusions:

  • Spatial temperature gradients can effectively attract cardiac rotors.
  • This approach offers a potential new method for localizing and targeting arrhythmogenic sources in AF.
  • Further research could lead to novel AF characterization and termination strategies during ablation.