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Dos Santos DS, Ossenkoppele B, Hopf YM, Soozande M, Noothout E, Vos HJ, Bosch JG, Pertijs MAP, Verweij MD, de Jong N. An Ultrasound Matrix Transducer for High-Frame-Rate 3-D Intra-cardiac Echocardiography. ULTRASOUND IN MEDICINE & BIOLOGY 2024; 50:285-294. [PMID: 38036310 DOI: 10.1016/j.ultrasmedbio.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 10/31/2023] [Accepted: 11/01/2023] [Indexed: 12/02/2023]
Abstract
OBJECTIVE Described here is the development of an ultrasound matrix transducer prototype for high-frame-rate 3-D intra-cardiac echocardiography. METHODS The matrix array consists of 16 × 18 lead zirconate titanate elements with a pitch of 160 µm × 160 µm built on top of an application-specific integrated circuit that generates transmission signals and digitizes the received signals. To reduce the number of cables in the catheter to a feasible number, we implement subarray beamforming and digitization in receive and use a combination of time-division multiplexing and pulse amplitude modulation data transmission, achieving an 18-fold reduction. The proposed imaging scheme employs seven fan-shaped diverging transmit beams operating at a pulse repetition frequency of 7.7 kHz to obtain a high frame rate. The performance of the prototype is characterized, and its functionality is fully verified. RESULTS The transducer exhibits a transmit efficiency of 28 Pa/V at 5 cm per element and a bandwidth of 60% in transmission. In receive, a dynamic range of 80 dB is measured with a minimum detectable pressure of 10 Pa per element. The element yield of the prototype is 98%, indicating the efficacy of the manufacturing process. The transducer is capable of imaging at a frame rate of up to 1000 volumes/s and is intended to cover a volume of 70° × 70° × 10 cm. CONCLUSION These advanced imaging capabilities have the potential to support complex interventional procedures and enable full-volumetric flow, tissue, and electromechanical wave tracking in the heart.
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Affiliation(s)
- Djalma Simões Dos Santos
- Laboratory of Medical Imaging, Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands.
| | - Boudewine Ossenkoppele
- Laboratory of Medical Imaging, Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | - Yannick M Hopf
- Electronic Instrumentation Laboratory, Delft University of Technology, Delft, The Netherlands
| | - Mehdi Soozande
- Department of Biomedical Engineering, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Emile Noothout
- Laboratory of Medical Imaging, Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | - Hendrik J Vos
- Laboratory of Medical Imaging, Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands; Department of Biomedical Engineering, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Johan G Bosch
- Department of Biomedical Engineering, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Michiel A P Pertijs
- Electronic Instrumentation Laboratory, Delft University of Technology, Delft, The Netherlands
| | - Martin D Verweij
- Laboratory of Medical Imaging, Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands; Department of Biomedical Engineering, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Nico de Jong
- Laboratory of Medical Imaging, Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands; Department of Biomedical Engineering, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands
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2
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Reddy VY, Kong MH, Petru J, Maan A, Funasako M, Minami K, Ruppersberg P, Dukkipati S, Neuzil P. Electrographic flow mapping of persistent atrial fibrillation: intra- and inter-procedure reproducibility in the absence of 'ground truth'. Europace 2023; 25:euad308. [PMID: 37956309 PMCID: PMC10642765 DOI: 10.1093/europace/euad308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 10/09/2023] [Indexed: 11/15/2023] Open
Abstract
AIMS Validating mapping systems that identify atrial fibrillation (AF) sources (focal/rotational activity) is confounded by the absence of ground truth. A key concern of prior mapping technologies is spatiotemporal instability, manifesting as poor map reproducibility. Electrographic flow (EGF) employs a novel algorithm that visualizes atrial electrical wavefront propagation to identify putative AF sources. We analysed both intra- (3 min) and inter- (>3 months) procedure EGF map reproducibility. METHODS AND RESULTS In 23 persistent AF patients, after pulmonary vein isolation (PVI), EGF maps were generated from 3 serial 1 min recordings using a 64-electrode basket mapping catheter (triplets) at right and left atrial locations. Source prevalence from map triplets was compared between recordings. Per protocol, 12 patients returned for 3-month remapping (1 non-inducible): index procedure post-PVI EGF maps were compared with initial EGF remapping at 3-month redo. Intra-procedure reproducibility: analysing 224 map triplets (111 right atrium, 113 left atrium) revealed a high degree of map consistency with minimal min-to-min shifts: 97 triplets (43%), exact match of leading sources on all 3 maps; 95 triplets (42%), leading source within 1 electrode space on 2 of 3 maps; and 32 triplets (14%), chaotic leading source pattern. Average deviation in source prevalence over 60 s was low (6.4%). Inter-procedure reproducibility: spatiotemporal stability of EGF mapping >3 months was seen in 16 of 18 (89%) sources mapped in 12 patients with (re)inducible AF. CONCLUSION Electrographic flow mapping generates reproducible intra- and inter-procedural maps, providing rationale for randomized clinical trials targeting these putative AF sources.
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Affiliation(s)
- Vivek Y Reddy
- Helmsley Electrophysiology Center, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, PO Box 1030, NewYork, NY 10029, USA
- Department of Cardiology, Homolka Hospital, Roentgenova 37/2, Prague 5, Czech Republic
| | | | - Jan Petru
- Department of Cardiology, Homolka Hospital, Roentgenova 37/2, Prague 5, Czech Republic
| | - Abhishek Maan
- Helmsley Electrophysiology Center, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, PO Box 1030, NewYork, NY 10029, USA
| | - Moritoshi Funasako
- Department of Cardiology, Homolka Hospital, Roentgenova 37/2, Prague 5, Czech Republic
| | - Kentaro Minami
- Department of Cardiology, Homolka Hospital, Roentgenova 37/2, Prague 5, Czech Republic
| | | | - Srinivas Dukkipati
- Helmsley Electrophysiology Center, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, PO Box 1030, NewYork, NY 10029, USA
| | - Petr Neuzil
- Department of Cardiology, Homolka Hospital, Roentgenova 37/2, Prague 5, Czech Republic
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Nakamura K, Sasaki T, Minami K, Aoki H, Kondo K, Miki Y, Goto K, Take Y, Kaseno K, Naito S. Noncontact Charge Density Mapping-Guided Ablation of Persistent Atrial Fibrillation With a Multiple Trigger-Based Mechanism. JACC Case Rep 2023; 21:101957. [PMID: 37719288 PMCID: PMC10500338 DOI: 10.1016/j.jaccas.2023.101957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/27/2023] [Accepted: 07/06/2023] [Indexed: 09/19/2023]
Abstract
We present a case of radiofrequency catheter ablation of persistent atrial fibrillation (AF) with a trigger-based mechanism, guided by novel noncontact charge density mapping, which resulted in the simultaneous achievement of the termination of AF and complete elimination of multiple triggers that induced repeated recurrences of AF immediately after cardioversion. (Level of Difficulty: Advanced.).
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Affiliation(s)
- Kohki Nakamura
- Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi City, Gunma, Japan
| | - Takehito Sasaki
- Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi City, Gunma, Japan
| | - Kentaro Minami
- Department of Cardiovascular Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi, Japan
| | - Hideyuki Aoki
- Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi City, Gunma, Japan
| | - Kan Kondo
- Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi City, Gunma, Japan
| | - Yuko Miki
- Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi City, Gunma, Japan
| | - Koji Goto
- Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi City, Gunma, Japan
| | - Yutaka Take
- Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi City, Gunma, Japan
| | - Kenichi Kaseno
- Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi City, Gunma, Japan
| | - Shigeto Naito
- Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi City, Gunma, Japan
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4
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Özgül O, Hermans BJ, van Hunnik A, Verheule S, Schotten U, Bonizzi P, Zeemering S. High-density and high coverage composite mapping of repetitive atrial activation patterns. Comput Biol Med 2023; 159:106920. [PMID: 37119551 DOI: 10.1016/j.compbiomed.2023.106920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 03/18/2023] [Accepted: 04/13/2023] [Indexed: 05/01/2023]
Abstract
BACKGROUND Repetitive atrial activation patterns (RAAPs) during atrial fibrillation (AF) may be associated with localized mechanisms that maintain AF. Current electro-anatomical mapping systems are unsuitable for analyzing RAAPs due to the trade-off between spatial coverage and electrode density in clinical catheters. This work proposes a technique to overcome this trade-off by constructing composite maps from spatially overlapping sequential recordings. METHODS High-density epicardial contact mapping was performed during open-chest surgery in goats (n=16, left and right atria) with 3 or 22 weeks of sustained AF (249-electrode array, electrode distance 2.4 mm). A dataset mimicking sequential recordings was generated by segmenting the grid into four spatially overlapping regions (each region 6.5 cm2, 48±10% overlap) without temporal overlap. RAAPs were detected in each region using recurrence plots of activation times. RAAPs in two different regions were joined in case of RAAP cross-recurrence between overlapping electrodes. We quantified the reconstruction success rate and quality of the composite maps. RESULTS Of 1021 RAAPs found in the full mapping array (32±13 per recording), 328 spatiotemporally stable RAAPs were analyzed. 247 composite maps were generated (75% success) with a quality of 0.86±0.21 (Pearson correlation). Success was significantly affected by the RAAP area. Quality was weakly correlated with the number of repetitions of RAAPs (r=0.13, p<0.05) and not affected by the atrial side (left or right) or AF duration (3 or 22 weeks of AF). CONCLUSIONS Constructing composite maps by combining spatially overlapping sequential recordings is feasible. Interpretation of these maps can play a central role in ablation planning.
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Affiliation(s)
- Ozan Özgül
- Department of Physiology, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands
| | - Ben Jm Hermans
- Department of Physiology, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands
| | - Arne van Hunnik
- Department of Physiology, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands
| | - Sander Verheule
- Department of Physiology, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands
| | - Ulrich Schotten
- Department of Physiology, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands.
| | - Pietro Bonizzi
- Department of Advanced Computing Sciences, Maastricht University, Maastricht, the Netherlands
| | - Stef Zeemering
- Department of Physiology, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands
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5
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Correlation between conduction velocity and frequency analysis in patients with atrial fibrillation using high-density charge mapping. Med Biol Eng Comput 2022; 60:3081-3090. [DOI: 10.1007/s11517-022-02659-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 08/22/2022] [Indexed: 10/14/2022]
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6
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Pope MTB, Kuklik P, Briosa E Gala A, Leo M, Mahmoudi M, Paisey J, Betts TR. Impact of Adenosine on Wavefront Propagation in Persistent Atrial Fibrillation: Insights From Global Noncontact Charge Density Mapping of the Left Atrium. J Am Heart Assoc 2022; 11:e021166. [PMID: 35621197 PMCID: PMC9238707 DOI: 10.1161/jaha.121.021166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Adenosine shortens action potential duration and refractoriness and provokes atrial fibrillation. This study aimed to evaluate the effect of adenosine on mechanisms of wavefront propagation during atrial fibrillation. Methods and Results The study included 22 patients undergoing catheter ablation for persistent atrial fibrillation. Left atrial mapping was performed using the AcQMap charge density system before and after administration of intravenous adenosine at 1 or more of 3 time points during the procedure (before pulmonary vein isolation, after pulmonary vein isolation, and after nonpulmonary vein isolation ablation). Wave‐front propagation patterns were evaluated allowing identification and quantification of localized rotational activation (LRA), localized irregular activation, and focal firing. Additional signal processing was performed to identify phase singularities and calculate global atrial fibrillation cycle length and dominant frequency. A total of 35 paired maps were analyzed. Adenosine shortened mean atrial fibrillation cycle length from 181.7±14.3 to 165.1±16.3, (mean difference 16.6 ms; 95% CI, 11.3–21.9, P<0.0005) and increased dominant frequency from 6.0±0.7 Hz to 6.6±0.8 Hz (95% CI, 0.4–0.9, P<0.0005). This was associated with a 50% increase in the number of LRA occurrences (16.1±7.6–24.2±8.1; mean difference 8.1, 95% CI, 4.1–12, P<0.0005) as well as a 20% increase in the number of phase singularities detected (30.1±7.8–36.6±9.3; mean difference 6.5; 95% CI, 2.6–10.0, P=0.002). The percentage of left atrial surface area with LRA increased with adenosine and 42 of 70 zones (60%) with highest density of LRA coincided with high density LRA zones at baseline with only 28% stable across multiple maps. Conclusions Adenosine accelerates atrial fibrillation and promotes rotational activation patterns with no impact on focal activation. There is little evidence that rotational activation seen with adenosine represents promising targets for ablation aimed at sites of stable arrhythmogenic sources in the left atrium.
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Affiliation(s)
- Michael T B Pope
- Oxford University Hospitals NHS Foundation Trust Oxford United Kingdom.,University of Southampton United Kingdom
| | - Pawel Kuklik
- Department of Cardiology Asklepios Clinic St. Georg Hamburg Germany
| | | | - Milena Leo
- Oxford University Hospitals NHS Foundation Trust Oxford United Kingdom
| | - Michael Mahmoudi
- University of Southampton United Kingdom.,Southampton University Hospitals NHS Foundation Trust Southampton United Kingdom
| | - John Paisey
- University of Southampton United Kingdom.,Southampton University Hospitals NHS Foundation Trust Southampton United Kingdom
| | - Timothy R Betts
- Oxford University Hospitals NHS Foundation Trust Oxford United Kingdom.,University of Oxford Biomedical Research Centre Oxford United Kingdom
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7
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Pope MT, Betts TR. Global Substrate Mapping and Targeted Ablation with Novel Gold-tip Catheter in De Novo Persistent AF. Arrhythm Electrophysiol Rev 2022; 11:e06. [PMID: 35755327 PMCID: PMC9204651 DOI: 10.15420/aer.2021.64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 02/14/2022] [Indexed: 11/04/2022] Open
Abstract
Results from catheter ablation for persistent AF are suboptimal, with no strategy other than pulmonary vein isolation showing clear benefit. Recently employed empirical strategies beyond pulmonary vein isolation involve widespread atrial ablation in all patients and do not take into account patient-specific differences in AF mechanisms or phenotype. Charge density mapping using the non-contact AcQMap system (Acutus Medical) allows visualisation of whole-chamber activation during AF and reveals localised patterns of complex activation thought to represent important mechanisms for AF maintenance that can be targeted with focal ablation. In this review, the authors outline the fundamentals of this technology, the initial data exploring the mechanistic role of activation patterns seen and the application to ablation of persistent AF.
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Affiliation(s)
- Michael Tb Pope
- Department of Cardiology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.,Department for Human Development and Health, University of Southampton, Southampton, UK
| | - Timothy R Betts
- Department of Cardiology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.,University of Oxford Biomedical Research Centre, Oxford, UK
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8
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Ramirez FD, Winterfield JR, Shi X, Chou D, Robinson D, Angel N, Shah P, Sorrell T, Ghafoori E, Vanderper A, Mariappan L, Soré B, Peyrat JM, Loyer V, Nakatani Y, Cochet H, Jaïs P. Non-contact whole-chamber charge density mapping of the left ventricle: preclinical evaluation in a sheep model. Heart Rhythm 2022; 19:828-836. [PMID: 35032670 DOI: 10.1016/j.hrthm.2022.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 01/06/2022] [Accepted: 01/07/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Conventional contact-based electroanatomic mapping is poorly suited for rapid or dynamic ventricular arrhythmias. Whole-chamber charge density (CD) mapping could efficiently characterize complex ventricular tachyarrhythmias and yield insights into their underlying mechanisms. OBJECTIVE This study sought to evaluate the feasibility and accuracy of non-contact whole-chamber left ventricular (LV) CD mapping, and to characterize CD activation patterns during sinus rhythm, ventricular pacing, and ventricular fibrillation (VF). METHODS Ischemic scar as defined by CD amplitude thresholds was compared to late gadolinium enhancement criteria on magnetic resonance imaging using an iterative closest point algorithm. Electrograms recorded at sites of tissue contact were compared to the nearest non-contact CD-derived electrograms to calculate signal morphology cross-correlations and time differences. Regions of consistently slow conduction were examined relative to areas of scar and to localized irregular activation (LIA) during VF. RESULTS Areas under receiver operating characteristic curves (AUCs) of CD-defined dense and total LV scar were 0.92 ± 0.03 and 0.87 ± 0.06, with accuracies of 0.86±0.03 and 0.80±0.05, respectively. Morphology cross-correlation between 8,677 contact and corresponding non-contact electrograms was 0.93±0.10, with a mean time difference of 2.5±5.6 msec. Areas of consistently slow conduction tended to occur at scar borders and exhibited spatial agreement with LIA during VF (AUC 0.90±0.02). CONCLUSION Non-contact LV CD mapping can accurately delineate ischemic scar. CD-derived ventricular electrograms correlate strongly with conventional contact-based electrograms. Regions with consistently slow conduction are often at scar borders and tend to harbor LIA during VF.
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Affiliation(s)
- F Daniel Ramirez
- Electrophysiology and Heart Modelling Institute (LIRYC), Bordeaux-Pessac, France; Department of Electrophysiology and Cardiac Stimulation, Centre Hospitalier Universitaire de Bordeaux, Bordeaux-Pessac, France; Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario Canada
| | - Jeffrey R Winterfield
- Division of Cardiology, Medical University of South Carolina, Charleston, South Carolina
| | | | | | - Dave Robinson
- Acutus Medical, Carlsbad, California; inHEART, Bordeaux-Pessac, France
| | | | | | | | | | | | | | | | | | - Virginie Loyer
- Electrophysiology and Heart Modelling Institute (LIRYC), Bordeaux-Pessac, France
| | - Yosuke Nakatani
- Electrophysiology and Heart Modelling Institute (LIRYC), Bordeaux-Pessac, France; Department of Electrophysiology and Cardiac Stimulation, Centre Hospitalier Universitaire de Bordeaux, Bordeaux-Pessac, France
| | - Hubert Cochet
- Electrophysiology and Heart Modelling Institute (LIRYC), Bordeaux-Pessac, France; Department of Electrophysiology and Cardiac Stimulation, Centre Hospitalier Universitaire de Bordeaux, Bordeaux-Pessac, France; inHEART, Bordeaux-Pessac, France
| | - Pierre Jaïs
- Electrophysiology and Heart Modelling Institute (LIRYC), Bordeaux-Pessac, France; Department of Electrophysiology and Cardiac Stimulation, Centre Hospitalier Universitaire de Bordeaux, Bordeaux-Pessac, France; inHEART, Bordeaux-Pessac, France.
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9
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Lee JMS, Nelson TA, Clayton RH, Kelland NF. Characterization of persistent atrial fibrillation with non‐contact charge density mapping and relationship to voltage. J Arrhythm 2021; 38:77-85. [PMID: 35222753 PMCID: PMC8851595 DOI: 10.1002/joa3.12661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 11/01/2021] [Accepted: 11/11/2021] [Indexed: 11/16/2022] Open
Abstract
Background Despite studies using localized high density contact mapping and lower resolution panoramic approaches, the mechanisms that sustain human persistent atrial fibrillation (AF) remain unresolved. Voltage mapping is commonly employed as a surrogate of atrial substrate to guide ablation procedures. Objective To study the distribution and temporal stability of activation during persistent AF using a global non‐contact charge density approach and compare the findings with bipolar contact mapping. Methods Patients undergoing either redo or de novo ablation for persistent AF underwent charge density and voltage mapping to guide the ablation procedure. Offline analysis was performed to measure the temporal stability of three specific charge density activation (CDA) patterns, and the degree of spatial overlap between CDA patterns and low voltage regions. Results CDA was observed in patient‐specific locations that partially overlapped, comprising local rotational activity (18% of LA), local irregular activity (41% of LA), and focal activity (39% of LA). Local irregular activity had the highest temporal stability. LA voltage was similar in regions with and without CDA. Conclusion In persistent AF, CDA patterns appear unrelated to low voltage areas but occur in varying locations with high temporal stability.
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Affiliation(s)
- Justin M. S. Lee
- Department of Cardiology Sheffield Teaching Hospitals NHS Trust Sheffield UK
- INSIGNEO Institute of In Silico MedicineUniversity of Sheffield Sheffield UK
| | - Thomas A. Nelson
- Department of Cardiology Sheffield Teaching Hospitals NHS Trust Sheffield UK
- INSIGNEO Institute of In Silico MedicineUniversity of Sheffield Sheffield UK
| | - Richard H. Clayton
- INSIGNEO Institute of In Silico MedicineUniversity of Sheffield Sheffield UK
- Department of Computer Science University of Sheffield Sheffield UK
| | - Nicholas F. Kelland
- Department of Cardiology Sheffield Teaching Hospitals NHS Trust Sheffield UK
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Baykaner T, Fazal M, Patel S, Zaman J. Is there rule to the chaos: Defining stable patterns in atrial fibrillation. J Cardiovasc Electrophysiol 2021; 32:2404-2407. [PMID: 34260124 DOI: 10.1111/jce.15169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 07/07/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Tina Baykaner
- Department of Cardiovascular Medicine, Stanford University, Stanford, California, USA
| | - Muhammad Fazal
- Department of Cardiovascular Medicine, Stanford University, Stanford, California, USA
| | - Sagar Patel
- Department of Cardiovascular Medicine, University of Southern California, Los Angeles, California, USA
| | - Junaid Zaman
- Department of Cardiovascular Medicine, University of Southern California, Los Angeles, California, USA
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