Iterative navigation of multipole diagnostic catheters to locate repeating‐pattern atrial fibrillation drivers

Autor: David T. Huang, Behnaz Ghoraani, Prasanth Ganesan, Elizabeth M. Cherry, Arkady M. Pertsov, Anthony Salmin
Jazyk: angličtina
Rok vydání: 2019
Předmět:
medicine.medical_treatment
Action Potentials
030204 cardiovascular system & hematology
Cardiac Catheters
03 medical and health sciences
Experimental
0302 clinical medicine
nonpulmonary‐vein sources
repeating‐pattern AF source detection
Heart Rate
Predictive Value of Tests
Physiology (medical)
Atrial Fibrillation
Medicine
Humans
Computer vision
Computer Simulation
030212 general & internal medicine
Diagnosis
Computer-Assisted
Electrodes
Fibrillatory conduction
business.industry
Models
Cardiovascular
Reproducibility of Results
Atrial fibrillation
Signal Processing
Computer-Assisted
Atrial tissue
Reentry
Original Articles
Equipment Design
Ablation
medicine.disease
Catheter
multipolar diagnostic catheter
atrial fibrillation (AF)
Ablation Therapy
atrial fibrillation ablation
Original Article
Artificial intelligence
Cardiology and Cardiovascular Medicine
business
Multipole expansion
Electrophysiologic Techniques
Cardiac
Algorithms
Zdroj: Journal of Cardiovascular Electrophysiology
ISSN: 1540-8167
1045-3873
Popis: Introduction Targeting repeating‐pattern atrial fibrillation (AF) sources (reentry or focal drivers) can help in patient‐specific ablation therapy for AF; however, the development of reliable and accurate tools for locating such sources remains a major challenge. We describe iterative catheter navigation (ICAN) algorithm to locate AF drivers using a conventional circular Lasso catheter. Methods and Results At each step, the algorithm analyzes 10 bipolar electrograms recoded at a given catheter location and the history of previous catheter movements to determine if the source is inside the catheter loop. If not, it calculates new coordinates and selects a new position for the catheter. The process continues until a source is located. The algorithm was evaluated in a computer model of atrial tissue with various degrees of fibrosis under a broad range of arrhythmia scenarios. The latter included slow and fast reentry, macroreentry, figure‐of‐eight reentry, and fibrillatory conduction. Depending on the initial distance of the catheter from the source and scenario, it took about 3 to 16 steps to localize an AF source. In 94% of cases, the identified location was within 4 mm from the source, independently of the initial position of the catheter. The algorithm worked equally well in the presence of patchy fibrosis, low‐voltage areas, fragmented electrograms, and dominant‐frequency gradients. Conclusions AF repeating‐pattern sources can be localized using circular catheters without the need to map the entire tissue. The proposed algorithm has the potential to become a useful tool for patient‐specific ablation of AF sources located outside the pulmonary veins.
Databáze: OpenAIRE
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