In Silico Investigation of the Effect of Atrial Fibrosis on High-Frequency Electrocardiogram

Atrial fibrosis plays an important role in the occurrence and maintenance of atrial fibrillation (AF). The assessment of atrial fibrosis is of great significance in the prediction, evaluation and treatment of AF. Currently, the development of high-frequency electrocardiogram (ECG) suggests that it may become a new and potential method to assess atrial fibrosis, which is relatively convenient and non-invasive. However, there is little relevant research on this issue. In this study, we investigated the effect of atrial fibrosis on high-frequency ECG using a two-dimensional (2D) atrial electrophysiological model. The effects of diffusion coefficient, fibrosis density and ion channel remodeling on high-frequency ECG were simulated. Simulation results demonstrated that the degree of atrial fibrosis (changes in diffusion coefficient and fibrosis density) would lead to a decrease in the maximum amplitude of about 30–63% on high-frequency ECG, while the ion channel remodeling would limitedly affect the maximum amplitude. The more severe the fibrosis density or the smaller the diffusion coefficient, the lower the maximum amplitude on high-frequency ECG. These findings may provide new insights into the assessment of atrial fibrosis by high-frequency ECG.