Atrial fibrillation is one of the most common arrhythmias and causes the heart not to contract properly to pump blood, which can lead to the formation of blood clots and the associated risks (heart attacks, strokes, etc.). Normally, patients with atrial fibrillation take anticoagulants, but the dosage must be adjusted and minimized as far as possible because these drugs have negative side effects, especially since they increase the risk of major bleeding. If internal, they can lead to brain bleeds, emboli, or abdominal bleeding.
One alternative to anticoagulants, or at least to reduce the necessary dose, is the implantation of a specific device in the left atrium of the heart. It is precisely in this part of the heart that blood clots can form when the heart tissue does not contract properly. The device blocks the flow of blood to the left atrium so as to prevent the formation of clots there. However, its placement must be carried out with great precision, adjusting it to the characteristics of each patient’s cardiac anatomy. Moreover, after the operation, their condition must continue to be monitored to calculate how much the anticoagulant dose can be reduced at any given time.
Combining these and other factors that affect the success of the operation and the patient’s recovery is enormously complex. However, recently scientists from the UPF created a pioneering new computational model that allows all these factors to be analysed in an integrated manner, using medical images provided by the Hospital Clínic de Barcelona. At the UPF, the study’s principal investigator is Oscar Camara, from the PhySense research group of the BCN MedTech Unit in the Engineering Department at the UPF, whilst at the Hospital Clínic Barcelona, it is Dr Xavier Freixa.
The model is based on a 3D reconstruction of each patient’s heart, created from a computed tomography (CT) scan of the left atrium, and can be a great help to the medical professionals who perform this surgical procedure or monitor patients before or after the operation. In fact, the renowned clinical journal JACC: Case Reports, published by the American College of Cardiology, has featured the study that describes this new computational model and the proof-of-concept test that was successfully developed with a patient with atrial fibrillation. Internationally, this is the first time that a medical journal has published a study on a computational model for this purpose.
The first author of the article is Maria Segarra, from the UPF’s PhySense research group, who highlights its potential: “the model can be of great help to doctors in determining the optimal position of the device for each patient, which is fundamental in the preoperative phase, and the necessary dose of anticoagulants required after the intervention, essential for the postoperative period.”
For Dr Xavier Freixa, of the Cardiology Department at the Clínic Barcelona “this model allows us to anticipate with much greater precision how to intervene in each patient and how to adjust anticoagulant treatment after the intervention, reducing risks and improving safety.”
It should be noted that, just after the device is implanted, anticoagulants cannot be stopped abruptly. On the one hand, the device is still a foreign body entering our body, and a certain period of adaptation is required. In fact, clots associated with the device’s implantation can occur for this very reason. However, once the device has been successfully integrated, the patient can gradually reduce the dose of anticoagulants they are taking, and even stop taking them. On the other hand, if they do not undergo surgery, they will have to take them indefinitely.
Having successfully passed the first test of the model
The researchers conducted this proof-of-concept study with a 78-year-old patient with atrial fibrillation and a history of stroke. The characteristics of this case thus made the operation to implant the device in the left atrium particularly advisable, in order to minimize the dose of anticoagulants to treat the arrhythmia. Using the new computational model, the optimal device position was determined in this case, and the required anticoagulant dose was established for the first few months after the intervention.
Great medical potential for the future
The proof of concept for his case validates the model’s effectiveness, which is expected to be tested with a large number of patients going forward. Taking into account its potential in the clinical setting, this computational model can be of great help to healthcare professionals involved in the preoperative, operative and postoperative phases of patients with atrial fibrillation who require the device in the left atrial appendage.
Reference article:
Segarra-Queralt, M, Molla, M, Barrouhou, M. et al. The Role of Anticoagulants After Left Atrial Appendage Occlusion. J Am Coll Cardiol Case Rep. null2025, 0 (0) . https://doi.org/10.1016/j.jaccas.2025.105838
