Fig. 1: The scheme and process of creating an AF digital twin and conducting a virtual AMD test.

a Creation of a patient-specific digital twin for patients with AF who underwent catheter ablation. b Construction of a 3D geometry with over 400,000 nodes arranged in a triangular mesh. Virtual maps were generated to characterize electrophysiological properties, including voltage, fibrosis, fiber orientation, and local activation time. c Virtual PVI procedure, with green lines representing ablation sites, pink areas indicating early activation sites, and yellow denoting pacing locations. d Virtual AMD testing under different conditions: no AMD (control), low dose, high dose, and toxic dose. e During constant 500 ms pacing across various AMD concentrations, surface EGMs were recorded, with time and voltage plotted to calculate human APD and dV/dt. f Segmentation method employed for the extra-pulmonary vein area of the LA. g Observation of AF post-ramp pacing over 32 seconds, with the creation of Smax maps using APD and diastolic interval, and DF maps during the maintenance phase of AF or AT between 17 and 23 seconds. EGMs show AF/AT maintenance until 32 seconds and termination before 16 seconds. AF atrial fibrillation, AMD amiodarone, AT atrial tachycardia, APD action potential duration, APD₉₀ 90% of action potential duration, CL cycle length, DF dominant frequency, dV/dt: peak upstroke velocity, EGM electrogram, Smax the maximal restitution slope of action potential duration, LA left atrium, PVI pulmonary vein isolation.