Characterization of human persistent atrial fibrillation electrograms using recurrence quantification analysis

Autor(es)

Almeida, Tiago P. ^{[1, 2]} ; Schlindwein, Fernando S. ^{[3, 4]} ; Salinet, Joao ^[1] ; Li, Xin ^[5] ; Chu, Gavin S. ^{[5, 6]} ; Tuan, Jiun H. ^[6] ; Stafford, Peter J. ^[6] ; Ng, G. Andre ^{[5, 6, 4]} ; Soriano, Diogo C. ^[1]

Afiliação do(s) autor(es)

^[1] Fed ABC Univ, Engn Modelling & Appl Social Sci Ctr, BR-09606045 Santo Andre - Brazil

^[2] ITA, Aeronaut Inst Technol, BR-12228900 Sao Jose Dos Campos - Brazil

^[3] Univ Leicester, Dept Engn, Leicester LE1 7RH, Leics - England

^[4] Glenfield Hosp, Leicester Cardiovasc Biomed Res Ctr, Natl Inst Hlth Res, Leicester LE3 9QP, Leics - England

^[5] Univ Leicester, Dept Cardiovasc Sci, Leicester LE1 7RH, Leics - England

^[6] Univ Hosp Leicester NHS Trust, Leicester LE1 5WW, Leics - England

• Tipo de documento: Artigo Científico
• Fonte: Chaos; v. 28, n. 8 AUG 2018.
• Citações Web of Science: 4

Resumo

Atrial fibrillation (AF) is regarded as a complex arrhythmia, with one or more co-existing mechanisms, resulting in an intricate structure of atrial activations. Fractionated atrial electrograms (AEGs) were thought to represent arrhythmogenic tissue and hence have been suggested as targets for radiofrequency ablation. However, current methods for ablation target identification have resulted in suboptimal outcomes for persistent AF (persAF) treatment, possibly due to the complex spatiotemporal dynamics of these mechanisms. In the present work, we sought to characterize the dynamics of atrial tissue activations from AEGs collected during persAF using recurrence plots (RPs) and recurrence quantification analysis (RQA). 797 bipolar AEGs were collected from 18 persAF patients undergoing pulmonary vein isolation (PVI). Automated AEG classification (normal vs. fractionated) was performed using the CARTO criteria (Biosense Webster). For each AEG, RPs were evaluated in a phase space estimated following Takens' theorem. Seven RQA variables were obtained from the RPs: recurrence rate; determinism; average diagonal line length; Shannon entropy of diagonal length distribution; laminarity; trapping time; and Shannon entropy of vertical length distribution. The results show that the RQA variables were significantly affected by PVI, and that the variables were effective in discriminating normal vs. fractionated AEGs. Additionally, diagonal structures associated with deterministic behavior were still present in the RPs from fractionated AEGs, leading to a high residual determinism, which could be related to unstable periodic orbits and suggesting a possible chaotic behavior. Therefore, these results contribute to a nonlinear perspective of the spatiotemporal dynamics of persAF. Published by AIP Publishing. (AU)

• Processo FAPESP: 17/00319-8 - Identificação do substrato atrial em pacientes com fibrilação atrial crônica utilizando modelos estatísticos multivariados e múltiplos atributos de eletrogramas atriais
• Beneficiário: Tiago Paggi de Almeida
• Modalidade de apoio: Bolsas no Brasil - Pós-Doutorado