Propagation of meandering rotors surrounded by areas of high dominant frequency in persistent atrial fibrillation
| Autor: | Peter J. Stafford, G. André Ng, Joao L Salinet, Tiago P. Almeida, Frederique J. Vanheusden, Maria S. Guillem, Xin Li, Fernando S. Schlindwein |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_treatment Catheter ablation Phase singularity Ablation 030204 cardiovascular system & hematology Pulmonary vein TECNOLOGIA ELECTRONICA 03 medical and health sciences 0302 clinical medicine Nuclear magnetic resonance Heart Conduction System Physiology (medical) Atrial Fibrillation medicine Humans Heart Atria Spatiotemporal correlation Dominant frequency business.industry Body Surface Potential Mapping Atrial fibrillation Equipment Design Middle Aged medicine.disease Persistent atrial fibrillation Catheter Ablation Female Electrophysiologic Techniques Cardiac Cardiology and Cardiovascular Medicine business 030217 neurology & neurosurgery Noncontact mapping |
| Zdroj: | RiuNet. Repositorio Institucional de la Universitat Politécnica de Valéncia instname Heart Rhythm |
| ISSN: | 1547-5271 |
| DOI: | 10.1016/j.hrthm.2017.04.031 |
| Popis: | [EN] [Background] Identification of arrhythmogenic regions remains a challenge in persistent atrial fibrillation (persAF). Frequency and phase analysis allows identification of potential ablation targets. [Objective] This study aimed to investigate the spatiotemporal association between dominant frequency (DF) and reentrant phase activation areas. [Methods] A total of 8 persAF patients undergoing first-time catheter ablation procedure were enrolled. A noncontact array catheter was deployed into the left atrium (LA) and 2048 atrial fibrillation electrograms (AEGs) were acquired for 15 seconds following ventricular far-field cancellation. DF and phase singularity (PS) points were identified from the AEGs and tracked over consecutive frames. The spatiotemporal correlation of high DF areas and PS points was investigated, and the organization index at the core of high-DF areas was compared with that of their periphery. [Results] The phase maps presented multiple simultaneous PS points that drift over the LA, with preferential locations. Regions displaying higher PS concentration showed a degree of colocalization with DF sites, with PS and DF regions being neighbors in 61.8% and with PS and DF regions overlapping in 36.8% of the time windows. Sites with highest DF showed a greater degree of organization at their core compared with their periphery. After ablation, the PS incidence reduced over the entire LA (36.2% ± 23.2%, P < .05), but especially at the pulmonary veins (78.6% ± 22.2%, P < .05). [Conclusion] Multiple PS points drifting over the LA were identified with their clusters correlating spatially with the DF regions. After pulmonary vein isolation, the PS¿s complexity was reduced, which supports the notion that PS sites represent areas of relevance to the atrial substrate. This work was supported by the Leicester NIHR Cardiovascular Biomedical Research Unit, UK. Dr. Salinet was supported by Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq, Brasil, N. 200598/2009-0) and Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP, Brasil, N. 2014/26066-0). Dr. Almeida was funded by Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq, Brazil, N. 200251/2012-0) and Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (Capes, Brazil). |
| Databáze: | OpenAIRE |
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