Getting to the heart of atrial fibrillation

In September 2026, Scientell science communicator Cintya Dharmayanti was thrilled to receive a Highly Commended award for her entry in the 2026 Australasian Medical Writers Association (AMWA) Early Career Award.

The award supports emerging medical writers as they build their careers in health and medical communication. Entrants submitted an original piece of up to 1,000 words on a health or medical topic, assessed for its accuracy, originality, relevance and ability to engage its intended audience.

Cintya’s story was inspired by the research of her sister, Dhani, into atrial fibrillation, a common heart rhythm disorder.

Read Cintya’s entry below.

Getting to the heart of atrial fibrillation

“My brother passed away when he was a baby from a congenital heart defect. I remember seeing how hard it was for my parents to go through, how strong they tried to be for my sister and me, and how much I wished that things could be different.” Reflecting on the death of her younger brother, it’s clear that Dr Dhani Dharmaprani is no stranger to matters of the heart.

She recalls growing up in Indonesia in the early 1990s, and how limited the technology was at the time to treat her brother’s heart condition. It was a time when resources were stretched thin and, for her family, when time stretched even thinner. But despite the tumultuous nature of this period, Dhani remembers one thing distinctly: the feeling. The one that inspired her to ‘fix people’s hearts’ when she grew up. Now, more than 20 years on, Dhani is an award-winning biomedical engineer at Flinders University in Adelaide, and her research is helping do exactly that.

Dhani’s work focuses on heart rhythm disorders, conditions where the heart beats in a rapid and irregular way. She explained that the heart’s pumping action is controlled by tiny electrical signals that are normally highly synchronised to ensure it pumps blood effectively.[i] However, disturbances in this electrical activity can lead to abnormal heart rhythms, or ‘quivering’ motions. When this occurs in the heart’s 2 upper chambers (called the atria), it’s known as atrial fibrillation (AF).[ii]

AF and its downstream effects place a huge burden on Australia’s healthcare system. In 2024, it contributed to over 17,000 deaths and more than 200,000 hospitalisations across the country.[iii] People with AF have up to a 5-fold greater risk of experiencing strokes,[iv] while people over 65,[v] Indigenous populations,[vi] and those with a lower socioeconomic status are also disproportionately affected.[vii] “This condition often progresses silently without people knowing, and most treatments are reactive; only given after the fact,” Dhani explained. “The current reality is that patients may trial many different medications, or go through invasive procedures, only to find that their AF hasn’t been successfully treated and they have to do it all over again.” 

One of the well-established treatments for AF is a procedure known as catheter ablation.[viii] Catheter ablation involves introducing a thin, flexible wire (called a catheter) through a large blood vessel in the leg and feeding it up to the heart. The tip of the catheter contains a device that can cause very targeted tissue damage. “The idea is that you have areas in the heart that possibly contribute to these abnormal electrical pathways. So, if we selectively and intentionally damage those areas, they can’t propagate abnormal electrical signals, which should restore the normal electrical activity of the heart,” Dhani explained.

However, Dhani emphasised that treatment is not one-size-fits-all. With catheter ablation success rates at about 50–70% for more persistent AF,[ix] there’s still a large population of patients who don’t respond to treatment. On the other hand, some patients with AF can have episodes that resolve completely on their own, without any treatment or intervention.[x]

“This raises an interesting question: can we categorise patients who do and don’t need treatment?” Dhani said. “If we understand what causes it, we can understand how best to treat it.”

So, what are the true underlying mechanisms of AF? Why do some people respond differently to treatment? And, most importantly, how do we treat them better?

These questions are at the heart of Dhani’s research. And unsurprisingly, with a background in engineering, she isn’t trying to find the answers under a microscope.

She’s using artificial intelligence (AI).

“My research leverages the rich clinical data that we have for these patients and uses mathematical approaches to understand hidden patterns in the data that might not be clear to the human eye,” Dhani explained. “In this context, machine learning and AI can be quite powerful, because rather than looking narrowly at one type of data, we can combine different types of data – imaging, physiological information, or patient characteristics – then put that into a model that can help pick out underlying patterns or trends.” [xi]

Using these inputs, her work aims to develop a ‘digital twin,’ or virtual replica, of the heart. [xii] This could be used to test different treatments from a computer, before trialling anything on a patient in real life. A digital twin of the heart would avoid the trial-and-error commonly associated with AF treatments and could help predict a patient’s clinical outcome.

The work has been supported by leading researchers, including Dr Carolyn Roney (Queen Mary University of London) and Professor Steven Niederer (Imperial College London), who mentored Dhani during a 3-month traineeship in England to develop skills in computational cardiac simulation. Dhani has now brought these skills back to Australian soil, where she hopes to establish her own research group and combine the mathematical simulations with clinical patient data to create more realistic representations of patients’ AF episodes.

Beyond her innate curiosity and love of problem-solving as a scientist, Dhani said the most rewarding thing is seeing how her research can be translated in practice. “Through my clinical colleagues and collaborators in the hospital, I can see how this work can trickle down and affect real patients. That’s really rewarding,” she said.

“After my brother’s passing, I had always thought I wanted to be a paediatrician, but I realised that path wasn’t for me. It gave me a bit of an identity crisis, because I hadn’t really thought of doing anything else,” Dhani mused. “But I had always been really interested in technology and computing, which I got from my dad, and medicine, inspired by my mum. So, I kind of blended both those things.”

“I coincidentally ended up in heart research through my PhD, but it’s exactly where I wanted to be,” she laughed. “And, as it turns out, I ended up finding a way to help ‘fix people’s hearts’ like I always wanted.”

[i] Coraboeuf E. Ionic basis of electrical activity in cardiac tissues. Am J Physiol Heart Circ Physiol. 1978 Feb 1;234(2):H101-H116. doi: 10.1152/ajpheart.1978.234.2.H101.

[ii] National Heart Foundation of Australia. What is atrial fibrillation? 2026. Accessed 6 July 2026. https://www.heartfoundation.org.au/your-heart/atrial-fibrillation

[iii] Australian Institute of Health and Welfare. Heart, stroke and vascular disease: Australian facts. 2026. Accessed 6 July 2026. https://www.aihw.gov.au/reports/heart-stroke-vascular-diseases/hsvd-facts/contents/all-heart-stroke-and-vascular-disease/atrial-fibrillation

[iv] Victor Chang Cardiac Research Institute. Atrial Fibrillation. 2026. Accessed 10 July 2026. https://www.victorchang.edu.au/heart-disease/atrial-fibrillation

[v] Karamichalakis N, Letsas KP, Vlachos K, Georgopoulos S, Bakalakos A, Efremidis M, Sideris A. Managing atrial fibrillation in the very elderly patient: challenges and solutions. Vasc Health Risk Manag. 2015 Oct 27;11:555-62. doi: 10.2147/VHRM.S83664.

[vi] Wong CX, Brooks AG, Cheng YH, Lau DH, Rangnekar G, Roberts-Thomson KC, Kalman JM, Brown A, Sanders P. Atrial fibrillation in Indigenous and non-Indigenous Australians: a cross-sectional study. BMJ Open. 2014 Oct 24;4(10):e006242. doi: 10.1136/bmjopen-2014-006242.

[vii] Essien UR, Kornej J, Johnson AE, Schulson LB, Benjamin EJ, Magnani JW. Social determinants of atrial fibrillation. Nat Rev Cardiol. 2021 Nov;18(11):763-773. doi: 10.1038/s41569-021-00561-0. 

[viii] Parameswaran, R., Al-Kaisey, A.M. & Kalman, J.M. Catheter ablation for atrial fibrillation: current indications and evolving technologies. Nat Rev Cardiol 18, 210–225 (2021). https://doi.org/10.1038/s41569-020-00451-x

[ix] Ganesan, A.N., Shipp, N.J., Brooks, A.G., Kuklik, P., Lau, D.H., Lim, H.S., Sullivan, T., Roberts‐Thomson, K.C. and Sanders, P., 2013. Long‐term outcomes of catheter ablation of atrial fibrillation: a systematic review and meta‐analysis. J Am Heart Assoc, 2(2), p.e004549.

[x] Nattel, S., Dobrev, D. Electrophysiological and molecular mechanisms of paroxysmal atrial fibrillation. Nat Rev Cardiol 13, 575–590 (2016). https://doi.org/10.1038/nrcardio.2016.118

[xi] Wang X, Bampton TJ, Dharmaprani D, Mahajan R, Palmer LJ. Machine learning and deep learning predictive models for prognosis in patients with atrial fibrillation: a systematic review and meta-analysis. BMJ Digital Health & AI. 2025;1:e000154. https://doi.org/10.1136/bmjdhai-2025-000154

[xii] Roney CH, Solis Lemus JA, Lopez Barrera C, Zolotarev A, Ulgen O, Kerfoot E, Bevis L, Misghina S, Vidal Horrach C, Jaffery OA, Ehnesh M, Rodero C, Dharmaprani D, Ríos-Muñoz GR, Ganesan A, Good WW, Neic A, Plank G, Hopman LHGA, Götte MJW, Honarbakhsh S, Narayan SM, Vigmond E, Niederer S. Constructing bilayer and volumetric atrial models at scale. Interface Focus. 2023 Dec 15;13(6):20230038. doi: 10.1098/rsfs.2023.0038.