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Register a new userCausal Scale Shift Associated with Phase Transition to Human Atrial Fibrillation
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An example of phase transition in natural complex systems is the qualitative and sudden change in the heart rhythm between sinus rhythm and atrial fibrillation (AF), the most common irregular heart rhythm in humans. While the system behavior is centrally controlled by the behavior of the sinoatrial node in sinus rhythm, the macro-scale collective behavior of the heart causes the micro-scale behavior in AF. To quantitatively analyze this causation shift associated with phase transition in human heart, we evaluated the causal architecture of the human cardiac system using the time series of multi-lead intracardiac unipolar electrograms in a series of spatiotemporal scales by generating a stochastic renormalization group. We found that the phase transition between sinus rhythm and AF is associated with a significant shift of the peak causation from macroscopic to microscopic scales. Causal architecture analysis may improve our understanding of causality in phase transitions in other natural and social complex systems.
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Atrial fibrillation (AF) is a leading cause of morbidity and mortality. AF prevalence increases with age, which is attributed to pathophysiological changes that aid AF initiation and perpetuation. Current state-of-the-art models are only capable of simulating short periods of atrial activity at high spatial resolution, whilst the majority of clinical recordings are based on infrequent temporal datasets of limited spatial resolution. Being able to estimate disease progression informed by both modelling and clinical data would be of significant interest. In addition an analysis of the temporal distribution of recorded fibrillation episodes AF density can provide insights into recurrence patterns. We present an initial analysis of the AF density measure using a simplified idealised stochastic model of a binary time series representing AF episodes. The future aim of this work is to develop robust clinical measures of progression which will be tested on models that generate long-term synthetic data. These measures would then be of clinical interest in deciding treatment strategies.
Mathematical models of cardiac electrical excitation are increasingly complex, with multiscale models seeking to represent and bridge physiological behaviours across temporal and spatial scales. The increasing complexity of these models makes it computationally expensive to both evaluate long term (>60 seconds) behaviour and determine sensitivity of model outputs to inputs. This is particularly relevant in models of atrial fibrillation (AF), where individual episodes last from seconds to days, and inter-episode waiting times can be minutes to months. Potential mechanisms of transition between sinus rhythm and AF have been identified but are not well understood, and it is difficult to simulate AF for long periods of time using state-of-the-art models. In this study, we implemented a Moe-type cellular automaton on a novel, topologically correct surface geometry of the left atrium. We used the model to simulate stochastic initiation and spontaneous termination of AF, arising from bursts of spontaneous activation near pulmonary veins. The simplified representation of atrial electrical activity reduced computational cost, and so permitted us to investigate AF mechanisms in a probabilistic setting. We computed large numbers (~10^5) of sample paths of the model, to infer stochastic initiation and termination rates of AF episodes using different model parameters. By generating statistical distributions of model outputs, we demonstrated how to propagate uncertainties of inputs within our microscopic level model up to a macroscopic level. Lastly, we investigated spontaneous termination in the model and found a complex dependence on its past AF trajectory, the mechanism of which merits future investigation.
Atrial Fibrillation (AF) is a common cardiac arrhythmia affecting a large number of people around the world. If left undetected, it will develop into chronic disability or even early mortality. However, patients who have this problem can barely feel its presence, especially in its early stage. A non-invasive, automatic, and effective detection method is therefore needed to help early detection so that medical intervention can be implemented in time to prevent its progression. Electrocardiogram (ECG), which records the electrical activities of the heart, has been widely used for detecting the presence of AF. However, due to the subtle patterns of AF, the performance of detection models have largely depended on complicated data pre-processing and expertly engineered features. In our work, we developed DenseECG, an end-to-end model based on 5 layers 1D densely connected convolutional neural network. We trained our model using the publicly available dataset from 2017 PhysioNet Computing in Cardiology(CinC) Challenge containing 8528 single-lead ECG recordings of short-term heart rhythms (9-61s). Our trained model was able to outperform the other state-of-the-art AF detection models on this dataset without complicated data pre-processing and expert-supervised feature engineering.
We demonstrate the robust scale-invariance in the probability density function (PDF) of detrended healthy human heart rate increments, which is preserved not only in a quiescent condition, but also in a dynamic state where the mean level of heart rate is dramatically changing. This scale-independent and fractal structure is markedly different from the scale-dependent PDF evolution observed in a turbulent-like, cascade heart rate model. These results strongly support the view that healthy human heart rate is controlled to converge continually to a critical state.
The electrical coupling between myocytes and fibroblasts and the spacial distribution of fibroblasts within myocardial tissues are significant factors in triggering and sustaining cardiac arrhythmias but their roles are poorly understood. This article describes both direct numerical simulations and an asymptotic theory of propagation and block of electrical excitation in a model of atrial tissue with myocyte-fibroblast coupling. In particular, three idealised fibroblast distributions are introduced: uniform distribution, fibroblast barrier and myocyte strait, all believed to be constituent blocks of realistic fibroblast distributions. Primary action potential biomarkers including conduction velocity, peak potential and triangulation index are estimated from direct simulations in all cases. Propagation block is found to occur at certain critical values of the parameters defining each idealised fibroblast distribution and these critical values are accurately determined. An asymptotic theory proposed earlier is extended and applied to the case of a uniform fibroblast distribution. Biomarker values are obtained from hybrid analytical-numerical solutions of coupled fast-time and slow-time periodic boundary value problems and compare well to direct numerical simulations. The boundary of absolute refractoriness is determined solely by the fast-time problem and is found to depend on the values of the myocyte potential and on the slow inactivation variable of the sodium current ahead of the propagating pulse. In turn, these quantities are estimated from the slow-time problem using a regular perturbation expansion to find the steady state of the coupled myocyte-fibroblast kinetics. The asymptotic theory gives a simple analytical expression that captures with remarkable accuracy the block of propagation in the presence of fibroblasts.
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