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Biomedical Engineering Graduate Student Seminar

Brennan Vogl

Advisor: Dr. Hoda Hatoum

Abstract

Atrial fibrillation (AF) is the most common arrhythmia in the world and is strongly associated with cardioembolic events. The physiological contraction of the heart may get compromised in patients with AF, which can result in blood stasis. Blood stasis is associated with the formation of thrombi—especially in the left atrial appendage (LAA)—that can embolize and cause strokes. Therefore, stroke prevention is the main concern in the management of AF. Catheter ablation has been introduced as an alternative to antiarrhythmic medications. It intends to restore the heart to its regular sinus rhythm and thus to reduce the risk of stroke. However, it is unclear how this procedure affects atrial flow dynamics in the long term. To better understand the effects of catheterization on atrial flow dynamics, patient specific models (before and after ablation) were assessed using a computation fluid dynamics (CFD) approach. Another approach to reduce the risk of stroke in patients with AF, is the occlusion of LAA. Anticoagulant medications are effective in mitigating strokes, but their many negative side effects make them unused in more than 50% of eligible patients. Although LAA occlusion devices have shown improved long-term outcomes, studies have also shown that 3.8% of patient’s develop device related thrombosis (DRT). The factors leading to DRT are still unclear despite several clinical studies investigating potential predictors. To this end, we have developed a combined finite element analysis and CFD approach to assess the hemodynamics around an LAAO device in patients who have and have not developed DRT.

About Brennan Vogl