Spatial modeling of the Wolff-Parkinson-White syndrome induced ventricular fibrillation

Aims: The goal of this study is to assess the influence of the accessory pathway´s (AcP) location and its repolarization period on the incidence of ventricular fibrillation (VF), in order to develop a non-invasive method able to select the most endangered patients that suffer from Wolff-Parkinson-White (WPW) syndrome. Methods: 12-lead ECG was recorded from 79 patients suffering from WPW (aged between 9 and 71 years) at the Cardiology Center of Timişoara (Romania), and the insertion place of AcP-s were determined using Arruda localization method. We developed a spatio-temporal computerized model of the whole heart. Using a high spatio-temporal resolution we modeled the paroxysm of atrial fibrillation (AF) that in the presence of an AcP caused a catastrophically rapid ventricular response with degeneration to VF. Results: Irrespectively of the AcP location, in presence of low AcP repolarization period (under 200 ms) the VF was developed for all 79 cases (average simulation time of 2 minutes 17 seconds using five stimulations per second). Conclusion: Low repolarization period is the most important danger to VF for patients suffering from WPW, while the connection place and the location of AcP has relatively reduced imperilment impact.