Fibrosis burden and spatial pattern affect left atrial appendage stasis in multi-beat multi-physics simulations

Purpose

Atrial fibrosis is associated with thromboembolic risk in atrial fibrillation, but it remains unclear how fibrosis-related contractile impairment alters blood transport in the left atrium (LA) and left atrial appendage (LAA). Prior multi-physics simulations coupling electromechanical (EM) and computational fluid dynamics (CFD) models showed that fibrosis impairs LA function and flow, but were limited to booster-only contraction and could not separate the effects of fibrosis burden from its spatial distribution. Here, we examined how fibrosis burden and spatial pattern independently relate to long-term LA and LAA hemodynamics in full-cycle, multi-beat simulations on a common LA anatomy.