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Atrial fibrillation (AF) flow significantly alters embolus paths, increasing trajectories to the common carotid arteries by 25%. This research investigates AF

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Area of Science:

  • Cardiovascular Science
  • Biomedical Engineering
  • Hemodynamics

Background:

  • Atrial fibrillation (AF) is the most common cardiac arrhythmia.
  • AF is a major risk factor for cardiogenic embolisms and acute ischemic stroke (AIS).
  • The influence of AF-induced flow dynamics on embolus trajectory remains under-investigated.

Purpose of the Study:

  • To experimentally investigate the trajectory paths of cardiogenic emboli under AF flow conditions.
  • To analyze embolus analog (EA) distribution in patient-specific vascular models.
  • To compare EA trajectories under steady, normal pulsatile, and AF pulsatile flow.

Main Methods:

  • Utilized a physiological simulation system with 720 bovine embolus analogs (EAs).
  • Employed four patient-specific vascular models.
  • Simulated three flow conditions: steady, normal pulsatile, and AF pulsatile flow.

Main Results:

  • EA trajectory paths correlated with flow rate splits (25-31%) in branching vessels.
  • AF flow increased EA trajectories to the left (LCCA) and right (RCCA) common carotid arteries by 25% compared to normal pulsatile flow.
  • More EAs traveled through the brachiocephalic trunk (BCT) than LCCA or left subclavian; however, among those reaching common carotids, LCCA showed greater EA affiliation.

Conclusions:

  • AF flow dynamics significantly impact embolus distribution, favoring pathways to the common carotid arteries.
  • Understanding these altered trajectories is crucial for stroke risk assessment in AF patients.
  • The study provides novel experimental insights into AF-related embolic stroke mechanisms.