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Personalizing therapy for atrial fibrillation: the role of stem cell and in silico disease models

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Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with substantial morbidity. There is considerable inter-patient variability in the pathologic processes that promote AF, and this variability… Click to show full abstract

Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with substantial morbidity. There is considerable inter-patient variability in the pathologic processes that promote AF, and this variability likely has a significant genetic basis. Clinically this is reflected by the observation that anti-arrhythmic drugs and interventional procedures have highly variable efficacy, and this highlights the need for adopting a more efficacious personalized approach. We explore recent advancements in both in silico and stem cell disease models that set the stage for a personalized approach. Specifically we highlight new mechanistic insights in AF; the future role of computational models in planning personalized ablation strategies; the potential role of stem cell models as a preclinical platform for drug development; and the potential to use gene-editing technology to create patient-specific stem cell models. Finally, we introduce the concept of integrating stem cell models with computational modelling to create a novel pipeline for patient-specific drug discovery and development.

Keywords: atrial fibrillation; disease models; stem cell; role; stem

Journal Title: Cardiovascular Research
Year Published: 2018

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