in-Silico TRials guide optimal stratification of ATrIal FIbrillation patients to Catheter Ablation vs pharmacological medicaTION: The i-STRATIFICATION Study

• Geometry with atrial region tags: atria_AA_X.alg  

• Fibers for the corresponding anatomy: atria_AA_X.fibers 

• Stimulation files for stimulating the sinoatrial node (SAN) and left pulmonary veins (lPV): atria_AA_X_SAN.pts and atria_AA_X_lPV.pts 

These atrial anatomies might be presented with absence of low voltage areas (FB_0) or with 15% low voltage areas in the right and left atrium (FB_1). Therefore, the actual names that can be found inside the Baseline folder are: 

• atria_AA_X_FB_0.alg 

• atria_AA_X_FB_1.alg 

• atria_AA_X_FB_0.fibers 

• atria_AA_X_FB_1.fibers 

Inside the Baseline folder there is an additional file with the suffix (*SV_AF.txt). This file includes the State Variables (or initial conditions) needed to impose AF in the tissue for each geometry: 

• atria_AA_1_SV_AF.txt 

Apart from the Baseline subfolder, each AtrialAnatomyX folder has 9 additional subfolders. These correspond to 9 catheter ablation treatments: 

• Ablation of low voltage areas (LVA) 

• Marshal-Plan 

• Left atrial anterior mitral line (MiLine) 

• MiLine and cavo-tricuspid isthmus block (MiLine+CTI) 

• MiLine+CTI + right atrial MiLine (MiLine+CTI+MiLineRA) 

• Pulmonary vein isolation (PVI) 

• Posterior wall isolation (PWI) 

• PWI plus mitral isthmus block (PWI+MI) 

• PWI+MI+CTI 

These treatment subfolders include the mesh file (.alg), fibers file (.fibers) and the initial conditions file to impose AF (*SV_AF.txt) considering the ablation lesion already in the tissue. For example, for PVI the files look like: 

• atria_AA_1_FB_0_PVI.alg (without low voltage areas) 

• atria_AA_1_FB_1_PVI.alg (with low voltage areas) 

• atria_AA_1_FB_0_PVI.fibers 

• atria_AA_1_FB_1_PVI.fibers 

• atria_AA_1_SV_AF_PVI.txt 

Additional to the atrial anatomies, configuration files for running simulations are provided in the folder ConfigurationFiles.  

• Each configuration file corresponds to a different virtual patient (VirtPat) and has the following name: 

• VirtPat_EP_X_AA_Y_FB_Z_Treatment.ini 

  • EP_X (electrophysiology): X is an integer ranging from 1 to 40. Different electrophysiology is reflected in the different scaling factors used for the maximal conductance of ionic currents. 

  • AA_Y (Atrial anatomy). Y is an integer ranging from 1 to 10. Call to the atrial meshes described above.

  • FB_Z (Fibrosis). Z is a boolean value, either 0 (no LVA) or 1 (15% LVA).

  • Treatment: This is a string that needs to be replaced by the treatment names described above: PVI, PWI, MiLine, etc.