Contribution of electrophysiological remodelling to generation of anatomical re-entries around the right pulmonary veins in human atrium: a simulation study

Atrial arrhythmias are characterised by rapid and irregular activation of atrium. In this study, the effects of remodelling on ionic currents were incorporated in a model of human atrial action potential and were integrated in a two-dimensional (2D) model of human left atrium tissue including orifices for right pulmonary veins. We examined the effects of atrial remodelling on atrial arrhythmias when ectopic beats between pulmonary veins were applied. Under normal tissue conditions, no re-entry phenomenon was induced. In atrial remodelling, action potential duration (APD), effective refractory period (ERP) and conduction velocity (CV) were decremented and stable re-entries around the right pulmonary veins were produced. Our study suggests that the electrical remodelling is a key factor to generate anatomical re-entries around the pulmonary veins.