Persistent Atrial Fibrillation Hierarchical Activation: from Highest DF Sites to Wave Fractionation at the Boundaries

Author(s)

Salinet, Joao ; Schlindwein, Fernando S. ; Stafford, Peter ; Almeida, Tiago P. ; Li, Xin ; Vanheusden, Frederique J. ; Guillem, Maria S. ; Ng, G. Andre ; IEEE

• Document type: Journal article
• Source: 2021 COMPUTING IN CARDIOLOGY (CINC); v. 44, p. 4-pg., 2017-01-01.

Abstract

Preclinical studies showed a relationship between high dominant frequency areas (HDFA) and wave fractionation, but evidence in patient who atrial fibrillation (AF) persists for long-term periods (persAF) it is not well defined. This study aims to assess the spatiotemporal organization characteristics at HDFAs is persAF and its impact after per standard pulmonary vein isolation (PVI). Eight persAF patients had a non-contact array catheter deployed into the left atrium to collect up to 2048 AF electrograms (AEG) for 15 s. AEGs were band-pass filtered (3-30 Hz) followed by ventricular farfield cancellation. DF between 4-10 Hz and its respective organization index (OI) were calculated (4 s with 50% overlap) to produce 3D DF and OI maps. HDFA defined as the regions within a 0.25 Hz drop from the highest DF were determined and their centre of gravity (CG) calculated. Highest DF sites showed a higher OI at their core when compared to the periphery (0.422 +/- 0.101 vs. 0.386 +/- 0.126, p=0.02) and increased again organization at sites distant from the HDFAs. Similarly, after PVI, OI remained higher as compared to their periphery (0.372 +/- 0.026 vs. 0.332 +/- 0.036, p=0.22), but with significant lower values when compared with baseline (p< 0.0001). PersAF patients showed higher organization in the HDFAs core when compared with its periphery. (AU)

• FAPESP's process: 17/11103-6 - Computing in Cardiology 2017
• Grantee: João Loures Salinet Júnior
• Support Opportunities: Research Grants - Meeting - Abroad
• FAPESP's process: 17/00319-8 - Atrial substrate identification in patients with chronic atrial fibrillation using multivariate statistical models and multiple attributes from atrial electrograms
• Grantee: Tiago Paggi de Almeida
• Support Opportunities: Scholarships in Brazil - Post-Doctoral