Mar 13, 2015

Rate control management of atrial fibrillation: may a mathematical model suggest an ideal heart rate?

PloS One
Matteo AnselminoLuca Ridolfi

Abstract

Despite the routine prescription of rate control therapy for atrial fibrillation (AF), clinical evidence demonstrating a heart rate target is lacking. Aim of the present study was to run a mathematical model simulating AF episodes with a different heart rate (HR) to predict hemodynamic parameters for each situation. The lumped model, representing the pumping heart together with systemic and pulmonary circuits, was run to simulate AF with HR of 50, 70, 90, 110 and 130 bpm, respectively. Left ventricular pressure increased by 57%, from 33.92±37.56 mmHg to 53.15±47.56 mmHg, and mean systemic arterial pressure increased by 27%, from 82.66±14.04 mmHg to 105.3±7.6 mmHg, at the 50 and 130 bpm simulations, respectively. Stroke volume (from 77.45±8.50 to 39.09±8.08 mL), ejection fraction (from 61.10±4.40 to 39.32±5.42%) and stroke work (SW, from 0.88±0.04 to 0.58±0.09 J) decreased by 50, 36 and 34%, at the 50 and 130 bpm simulations, respectively. In addition, oxygen consumption indexes (rate pressure product - RPP, tension time index per minute - TTI/min, and pressure volume area per minute - PVA/min) increased from the 50 to the 130 bpm simulation, respectively, by 186% (from 5598±1939 to 15995±3219 mmHg/min), 56% (from 2094±265 to 32...Continue Reading

Mentioned in this Paper

Prescription Procedure
Arterial Pulse Pressure
Study
Exertion
Lung
Episodic Ataxia Type 1
Left Ventricular Structure
Cardiovascular System
Digoxin
DSG3

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