Preliminary Findings on the Correlation between Left Atrial Wall Shear Stress and Atrial Endocardial Voltage in Atrial Fibrillation

Left atrial (LA) wall fibrosis plays a significant role in atrial fibrillation (AF) due to atypical electrophysiological characteristics of such tissue substrate. However, the mechanism underlying the development of such fibrosis is poorly understood. The purpose of this preliminary study was to investigate the possible association between LA wall shear stress (WSS), assessed using computational fluid dynamics (CFD), and areas with fibrosis, defined by low values of bipolar voltage (BV<0.5 mV). Simulations were run on patient-specific dynamic LA models derived from MRI and CT data of 10 AF patients. The focus of the analysis was to assess the impact of the computational model on the distribution of fluid dynamic parameters and the association between LA WSS and endocardial voltage. Our preliminary findings suggest that the computational domain affects CFD simulation results, with more consistent findings for the MRI-derived than for the CT-derived model.