An in vitro assessment of atrial fibrillation flow types on cardiogenic emboli trajectory paths

TY - JOUR

T1 - An in vitro assessment of atrial fibrillation flow types on cardiogenic emboli trajectory paths

AU - Malone, Fiona

AU - McCarthy, Eugene

AU - Delassus, Patrick

AU - Buhk, Jan Hendrick

AU - Fiehler, Jens

AU - Morris, Liam

N1 - Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: Galway Mayo Institute of Technology 40th anniversary seed funding. Publisher Copyright: © IMechE 2020. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.

PY - 2020/12

Y1 - 2020/12

N2 - Atrial fibrillation is the most significant contributor to thrombus formation within the heart and is responsible for 45% of all cardio embolic strokes, which account for approximately 15% of acute ischemic strokes cases worldwide. Atrial fibrillation can result in a reduction of normal cardiac output and cycle length of up to 30% and 40%, respectively. A total of 240 embolus analogues were released into a thin-walled, patient-specific aortic arch under normal (60 embolus analogues) and varying atrial fibrillation (180 embolus analogues) pulsatile flow conditions. Under healthy flow conditions (n = 60), the embolus analogues tended to follow the flow rate split through each outlet vessel. There was an increase in clot trajectories along the common carotid arteries under atrial fibrillation flow conditions. A shorter pulse period (0.3 s) displayed the highest percentage of clots travelling to the brain (24%), with a greater percentage of clots travelling through the left common carotid artery (17%). This study provides an experimental insight into the effect varying cardiac output and cycle length can have on the trajectory of a cardiac source blood clots travelling to the cerebral vasculature and possibly causing a stroke.

AB - Atrial fibrillation is the most significant contributor to thrombus formation within the heart and is responsible for 45% of all cardio embolic strokes, which account for approximately 15% of acute ischemic strokes cases worldwide. Atrial fibrillation can result in a reduction of normal cardiac output and cycle length of up to 30% and 40%, respectively. A total of 240 embolus analogues were released into a thin-walled, patient-specific aortic arch under normal (60 embolus analogues) and varying atrial fibrillation (180 embolus analogues) pulsatile flow conditions. Under healthy flow conditions (n = 60), the embolus analogues tended to follow the flow rate split through each outlet vessel. There was an increase in clot trajectories along the common carotid arteries under atrial fibrillation flow conditions. A shorter pulse period (0.3 s) displayed the highest percentage of clots travelling to the brain (24%), with a greater percentage of clots travelling through the left common carotid artery (17%). This study provides an experimental insight into the effect varying cardiac output and cycle length can have on the trajectory of a cardiac source blood clots travelling to the cerebral vasculature and possibly causing a stroke.

KW - Atrial fibrillation

KW - cardiac output

KW - cardiogenic emboli

KW - embolus analogues

KW - patient-specific models

KW - pulse period

KW - stroke

UR - http://www.scopus.com/inward/record.url?scp=85089020330&partnerID=8YFLogxK

U2 - 10.1177/0954411920946873

DO - 10.1177/0954411920946873

M3 - SCORING: Journal article

C2 - 32755282

AN - SCOPUS:85089020330

VL - 234

SP - 1421

EP - 1431

JO - P I MECH ENG H

JF - P I MECH ENG H

SN - 0954-4119

IS - 12

ER -