{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T03:17:57Z","timestamp":1783567077516,"version":"3.55.0"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2024,8,23]],"date-time":"2024-08-23T00:00:00Z","timestamp":1724371200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Union\u2019s Horizon 2020 research and innovation programme"},{"name":"Marie Sk\u0142odowska-Curie","award":["860974"],"award-info":[{"award-number":["860974"]}]},{"name":"Leibniz ScienceCampus"},{"DOI":"10.13039\/501100001664","name":"The Leibniz Association","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001664","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,10,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>The effective refractory period (ERP) is one of the main electrophysiological properties governing arrhythmia, yet ERP personalization is rarely performed when creating patient-specific computer models of the atria to inform clinical decision-making. This study evaluates the impact of integrating clinical ERP measurements into personalized in silico models on arrhythmia vulnerability.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Clinical ERP measurements were obtained in seven patients from multiple locations in the atria. Atrial geometries from the electroanatomical mapping system were used to generate personalized anatomical atrial models. The Courtemanche M. et al. cellular model was adjusted to reproduce patient-specific ERP. Four modeling approaches were compared: homogeneous (A), heterogeneous (B), regional (C), and continuous (D) ERP distributions. Non-personalized approaches (A and B) were based on literature data, while personalized approaches (C and D) were based on patient measurements. Modeling effects were assessed on arrhythmia vulnerability and tachycardia cycle length, with sensitivity analysis on ERP measurement uncertainty. Mean vulnerability was 3.4 \u00b1 4.0%, 7.7 \u00b1 3.4%, 9.0 \u00b1 5.1%, and 7.0 \u00b1 3.6% for scenarios A\u2013D, respectively. Mean tachycardia cycle length was 167.1 \u00b1 12.6\u2005ms, 158.4 \u00b1 27.5\u2005ms, 265.2 \u00b1 39.9\u2005ms, and 285.9 \u00b1 77.3\u2005ms for scenarios A\u2013D, respectively. Incorporating perturbations to the measured ERP in the range of 2, 5, 10, 20, and 50\u2005ms changed the vulnerability of the model to 5.8 \u00b1 2.7%, 6.1 \u00b1 3.5%, 6.9 \u00b1 3.7%, 5.2 \u00b1 3.5%, and 9.7 \u00b1 10.0%, respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Increased ERP dispersion had a greater effect on re-entry dynamics than on vulnerability. Inducibility was higher in personalized scenarios compared with scenarios with uniformly reduced ERP; however, this effect was reversed when incorporating fibrosis informed by low-voltage areas. Effective refractory period measurement uncertainty up to 20\u2005ms slightly influenced vulnerability. Electrophysiological personalization of atrial in silico models appears essential and requires confirmation in larger cohorts.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/europace\/euae215","type":"journal-article","created":{"date-parts":[[2024,8,23]],"date-time":"2024-08-23T23:33:28Z","timestamp":1724456008000},"source":"Crossref","is-referenced-by-count":12,"title":["Impact of effective refractory period personalization on arrhythmia vulnerability in patient-specific atrial computer models"],"prefix":"10.1093","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-9762-2982","authenticated-orcid":false,"given":"Patricia","family":"Mart\u00ednez D\u00edaz","sequence":"first","affiliation":[{"name":"Department of Electrical Engineering and Information Technology, Institute of Biomedical Engineering, Karlsruhe Institute of Technology (KIT) , Fritz-Haber, Weg 1 30.33, 76131, Karlsruhe 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