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Dynamic Behavior of Rotors during Human Persistent Atrial Fibrillation as observed using Non-Contact Mapping
conference contribution
posted on 2016-11-14, 11:19 authored by Nawshin Dastagir, Tiago P. Almeida, Xin Li, F. J. Vanheusden, Gavin S . Chu, Peter J. Stafford, G. André Ng, Fernando S. SchlindweinRotors have been related to atrial fibrillation (AF)
maintenance. We analyzed the behavior of rotors in
persistent AF (persAF) utilizing a novel non-contact
methodology and compared this to real time dominant
frequency (DF) analysis.
2048 noncontact virtual unipolar atrial electrograms
(VEGMs) were collected simultaneously (EnSite Array,
St. Jude Medical) from 10 persAF patients (duration: 34 ±
25 months) undergoing left atrial (LA) ablation. After
QRST-removal, FFT was used to identify the global DF of
the LA (range 4 - 10 Hz; 1 s time-window; 50 % overlap;
highest DF (HDF) (DF -0.25 Hz); up to 20 s/patient). The
organization index (OI) was measured and phase was
found via Hilbert-transform.
Phase singularities (PSs) were tracked and were
categorized according to their lifespan into short (lifespan
<100 ms) and long lived (rotors) (lifespan ≥100 ms). A
total of 4578 PSs were tracked. 5.05 % (IQR: 2.75 ~ 30.25
%) of the tracked PSs were long-lived and were observed
in 11 % (IQR: 2.75 ~ 17.5 %) of the windows. The
windows with rotors showed significantly higher HDF
(mean ± SD, 8.0 ± 0.43 Hz vs 7.71 ± 0.50 Hz, p< 0.0001)
and lower OI (0.76 ± 0.04 vs 0.79 ± 0.03, p< 0.0001) when
compared with the short-lived PSs windows.
During persAF, the LA showed distinct behaviors as
characterized by rotors. Often, no rotors were observed
during sustained AF and, when present, the rotors
continually switched between organized and disorganized
behaviors. Long-lived rotors correlated with higher atrial
rates. Our results suggest that rotors are not the sole
perpetuating mechanism in persAF.
Funding
The work described in this paper is part of the research portfolio supported by the Leicester National Institute for Health Research (NIHR) Biomedical Research Unit (BRU) in Cardiovascular Disease, UK. TPA and JLS have received research grants from Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil. The authors would like to acknowledge the financial support from the (NIHR) Leicester Cardiovascular BRU and CNPq.
History
Citation
Computing in Cardiology 2016, 43, pp. 241-244Author affiliation
/Organisation/COLLEGE OF SCIENCE AND ENGINEERING/Department of EngineeringSource
CinC 2016, Computing in Cardiology 2016, CanadaVersion
- VoR (Version of Record)