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Rate Control Management of Atrial Fibrillation: May a Mathematical Model Suggest an Ideal Heart Rate?

BACKGROUND: 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 p...

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Autores principales: Anselmino, Matteo, Scarsoglio, Stefania, Camporeale, Carlo, Saglietto, Andrea, Gaita, Fiorenzo, Ridolfi, Luca
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4357457/
https://www.ncbi.nlm.nih.gov/pubmed/25764321
http://dx.doi.org/10.1371/journal.pone.0119868
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author Anselmino, Matteo
Scarsoglio, Stefania
Camporeale, Carlo
Saglietto, Andrea
Gaita, Fiorenzo
Ridolfi, Luca
author_facet Anselmino, Matteo
Scarsoglio, Stefania
Camporeale, Carlo
Saglietto, Andrea
Gaita, Fiorenzo
Ridolfi, Luca
author_sort Anselmino, Matteo
collection PubMed
description BACKGROUND: 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. METHODS: 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. RESULTS: 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 3257±301 mmHg s/min) and 102% (from 57.99±17.90 to 117.4±26.0 J/min). In fact, left ventricular efficiency (SW/PVA) decreased from 80.91±2.91% at 50 bpm to 66.43±3.72% at the 130 bpm HR simulation. CONCLUSION: Awaiting compulsory direct clinical evidences, the present mathematical model suggests that lower HRs during permanent AF relates to improved hemodynamic parameters, cardiac efficiency, and lower oxygen consumption.
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spelling pubmed-43574572015-03-23 Rate Control Management of Atrial Fibrillation: May a Mathematical Model Suggest an Ideal Heart Rate? Anselmino, Matteo Scarsoglio, Stefania Camporeale, Carlo Saglietto, Andrea Gaita, Fiorenzo Ridolfi, Luca PLoS One Research Article BACKGROUND: 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. METHODS: 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. RESULTS: 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 3257±301 mmHg s/min) and 102% (from 57.99±17.90 to 117.4±26.0 J/min). In fact, left ventricular efficiency (SW/PVA) decreased from 80.91±2.91% at 50 bpm to 66.43±3.72% at the 130 bpm HR simulation. CONCLUSION: Awaiting compulsory direct clinical evidences, the present mathematical model suggests that lower HRs during permanent AF relates to improved hemodynamic parameters, cardiac efficiency, and lower oxygen consumption. Public Library of Science 2015-03-12 /pmc/articles/PMC4357457/ /pubmed/25764321 http://dx.doi.org/10.1371/journal.pone.0119868 Text en © 2015 Anselmino et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Anselmino, Matteo
Scarsoglio, Stefania
Camporeale, Carlo
Saglietto, Andrea
Gaita, Fiorenzo
Ridolfi, Luca
Rate Control Management of Atrial Fibrillation: May a Mathematical Model Suggest an Ideal Heart Rate?
title Rate Control Management of Atrial Fibrillation: May a Mathematical Model Suggest an Ideal Heart Rate?
title_full Rate Control Management of Atrial Fibrillation: May a Mathematical Model Suggest an Ideal Heart Rate?
title_fullStr Rate Control Management of Atrial Fibrillation: May a Mathematical Model Suggest an Ideal Heart Rate?
title_full_unstemmed Rate Control Management of Atrial Fibrillation: May a Mathematical Model Suggest an Ideal Heart Rate?
title_short Rate Control Management of Atrial Fibrillation: May a Mathematical Model Suggest an Ideal Heart Rate?
title_sort rate control management of atrial fibrillation: may a mathematical model suggest an ideal heart rate?
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4357457/
https://www.ncbi.nlm.nih.gov/pubmed/25764321
http://dx.doi.org/10.1371/journal.pone.0119868
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