Preliminary Simulation Study of Atrial Fibrillation Treatment Procedure Based on A Detailed Human Atrial Model

Atrial Fibrillation (AF) is the most common sustained cardiac arrhythmia in clinical practice. Surgical ablation is a therapeutic procedure that creates lines of conduction block to interrupt the maintenance of AF. However, surgical AF ablation procedures are largely based on empirical considerations, and may not be optimized. In this study, based on a detailed human atrial model with fiber orientation, eight AF surgical ablation procedures, including the clinical gold standard Cox-Maze III, incomplete Maze-III, mini-Maze, and 5 modified Maze-Ⅲ procedures, were simulated and evaluated. The simulation results indicated the importance of the ablation line from the connection of superior and inferior vena cava to the atrial septum, and also showed that, in comparison with the clinical standard Maze-Ⅲ procedure, our modified Maze-Ⅲ procedures with fewer ablation lines achieved similar ablation effectiveness. In conclusion, this preliminary simulation study has demonstrated that current surgical AF ablation procedure is not optimal and a refinement could be suggested. It also suggests that computational heart modeling and simulation is an important tool to evaluate AF treatment strategies.