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An atrioventricular node model incorporating autonomic tone

Plappert, Felix LU ; Wallman, Mikael ; Abdollahpur, Mostafa LU ; Platonov, Pyotr LU ; Östenson, Sten and Sandberg, Frida LU (2022) In Frontiers in Physiology 13(976468).
Abstract
The response to atrial fibrillation (AF) treatment is differing widely among patients, and a better understanding of the factors that contribute to these differences is needed. One important factor may be differences in the autonomic nervous system (ANS) activity. The atrioventricular (AV) node plays an important role during AF in modulating heart rate. To study the effect of the ANS-induced activity on the AV nodal function in AF, mathematical modelling is a valuable tool. In this study, we present an extended AV node model that incorporates changes in autonomic tone. The extension was guided by a distribution-based sensitivity analysis and incorporates the ANS-induced changes in the refractoriness and conduction delay. Simulated RR... (More)
The response to atrial fibrillation (AF) treatment is differing widely among patients, and a better understanding of the factors that contribute to these differences is needed. One important factor may be differences in the autonomic nervous system (ANS) activity. The atrioventricular (AV) node plays an important role during AF in modulating heart rate. To study the effect of the ANS-induced activity on the AV nodal function in AF, mathematical modelling is a valuable tool. In this study, we present an extended AV node model that incorporates changes in autonomic tone. The extension was guided by a distribution-based sensitivity analysis and incorporates the ANS-induced changes in the refractoriness and conduction delay. Simulated RR series from the extended model driven by atrial impulse series obtained from clinical tilt test data were qualitatively evaluated against clinical RR series in terms of heart rate, RR series variability and RR series irregularity. The changes to the RR series characteristics during head-down tilt were replicated by a 10% decrease in conduction delay, while the changes during head-up tilt were replicated by a 5% decrease in the refractory period and a 10% decrease in the conduction delay. We demonstrate that the model extension is needed to replicate ANS-induced changes during tilt, indicating that the changes in RR series characteristics could not be explained by changes in atrial activity alone. (Less)
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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
atrial fibrillation, atrioventricular node, autonomic tone, tilt test, mathematical modeling, ECG, RR series characteristics, sample entropy
in
Frontiers in Physiology
volume
13
issue
976468
pages
13 pages
publisher
Frontiers Media S. A.
external identifiers
  • scopus:85139010999
  • pmid:36187793
ISSN
1664-042X
DOI
10.3389/fphys.2022.976468
project
Ph.D. project: Diagnostic Biomarkers in Atrial Fibrillation - Autonomic Nervous System Induced Modulation as a Sign of Disease Progression
Diagnostic Biomarkers in Atrial Fibrillation - Autonomic Nervous System Response as a Sign of Disease Progression
language
English
LU publication?
yes
id
6abafc26-0a2a-4e84-ae40-3332a5635f69
date added to LUP
2022-09-15 09:49:34
date last changed
2023-04-05 21:28:24
@article{6abafc26-0a2a-4e84-ae40-3332a5635f69,
  abstract     = {{The response to atrial fibrillation (AF) treatment is differing widely among patients, and a better understanding of the factors that contribute to these differences is needed. One important factor may be differences in the autonomic nervous system (ANS) activity. The atrioventricular (AV) node plays an important role during AF in modulating heart rate. To study the effect of the ANS-induced activity on the AV nodal function in AF, mathematical modelling is a valuable tool. In this study, we present an extended AV node model that incorporates changes in autonomic tone. The extension was guided by a distribution-based sensitivity analysis and incorporates the ANS-induced changes in the refractoriness and conduction delay. Simulated RR series from the extended model driven by atrial impulse series obtained from clinical tilt test data were qualitatively evaluated against clinical RR series in terms of heart rate, RR series variability and RR series irregularity. The changes to the RR series characteristics during head-down tilt were replicated by a 10% decrease in conduction delay, while the changes during head-up tilt were replicated by a 5% decrease in the refractory period and a 10% decrease in the conduction delay. We demonstrate that the model extension is needed to replicate ANS-induced changes during tilt, indicating that the changes in RR series characteristics could not be explained by changes in atrial activity alone.}},
  author       = {{Plappert, Felix and Wallman, Mikael and Abdollahpur, Mostafa and Platonov, Pyotr and Östenson, Sten and Sandberg, Frida}},
  issn         = {{1664-042X}},
  keywords     = {{atrial fibrillation; atrioventricular node; autonomic tone; tilt test; mathematical modeling; ECG; RR series characteristics; sample entropy}},
  language     = {{eng}},
  month        = {{09}},
  number       = {{976468}},
  publisher    = {{Frontiers Media S. A.}},
  series       = {{Frontiers in Physiology}},
  title        = {{An atrioventricular node model incorporating autonomic tone}},
  url          = {{https://lup.lub.lu.se/search/files/124044867/Plappert_2022_An_atrioventricular_node_model_incorporating_autonomic_tone.pdf}},
  doi          = {{10.3389/fphys.2022.976468}},
  volume       = {{13}},
  year         = {{2022}},
}