Identification of Rotors during Human Atrial Fibrillation Using Contact Mapping and Phase Singularity Detection: Technical Considerations
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Identification of Rotors during Human Atrial Fibrillation Using Contact Mapping and Phase Singularity Detection: Technical Considerations. / Kuklik, Pawel; Zeemering, Stef; van Hunnik, Arne; Maesen, Bart; Pison, Laurent; Lau, Dennis H; Maessen, Jos; Podziemski, Piotr; Meyer, Christian; Schaffer, Benjamin; Crijns, Harry; Willems, Stephan; Schotten, Ulrich.
In: IEEE T BIO-MED ENG, Vol. 64, No. 2, 02.2017, p. 310-318.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Identification of Rotors during Human Atrial Fibrillation Using Contact Mapping and Phase Singularity Detection: Technical Considerations
AU - Kuklik, Pawel
AU - Zeemering, Stef
AU - van Hunnik, Arne
AU - Maesen, Bart
AU - Pison, Laurent
AU - Lau, Dennis H
AU - Maessen, Jos
AU - Podziemski, Piotr
AU - Meyer, Christian
AU - Schaffer, Benjamin
AU - Crijns, Harry
AU - Willems, Stephan
AU - Schotten, Ulrich
PY - 2017/2
Y1 - 2017/2
N2 - OBJECTIVE: To explore technical challenges of phase singularity (PS) mapping during atrial fibrillation (AF) using direct contact electrograms.METHODS: AF mapping was performed in high-density epicardial recordings of human paroxysmal (PAF) or persistent (PersAF) (N = 20 pts) AF with an array of 16 × 16 electrodes placed on atrial epicardium. PS points were detected using subsets of electrodes forming rings of varying sizes.RESULTS: PS detection using a 2 × 2 electrode ring identified 0.88 ± 1.00 PS/s in PAF group and 3.91 ± 2.51 per s in PersAF group (p < 0.001) in 2.4 × 2.4 cm mapping area. All detected PS had a short lifespan with the longest being 1100 ms (6.8 rotations). Exploration of the PS detection in a numerical model demonstrated that at least eight electrodes are required to avoid frequent false positive PS detection due to chance. Application of a detection grid consisting a double ring of electrodes (2 × 2 and 4 × 4 rings) decreased the number of false positive detections. The double ring was more resilient to electrode swapping (with just three instances of false positives versus 4380 false positives using 2 × 2 ring).CONCLUSIONS: The number of detected rotors critically depends upon the parameters of the detection algorithm, especially the number of electrodes used to detect PS. Based on our results, we recommend double ring comprised of 2 × 2 and 4 × 4 grid of electrodes for robust rotor detection.SIGNIFICANCE: Great methodological care has to be taken before equating detected PS with rotating waves and using PS detection algorithms to guide catheter ablation of AF.
AB - OBJECTIVE: To explore technical challenges of phase singularity (PS) mapping during atrial fibrillation (AF) using direct contact electrograms.METHODS: AF mapping was performed in high-density epicardial recordings of human paroxysmal (PAF) or persistent (PersAF) (N = 20 pts) AF with an array of 16 × 16 electrodes placed on atrial epicardium. PS points were detected using subsets of electrodes forming rings of varying sizes.RESULTS: PS detection using a 2 × 2 electrode ring identified 0.88 ± 1.00 PS/s in PAF group and 3.91 ± 2.51 per s in PersAF group (p < 0.001) in 2.4 × 2.4 cm mapping area. All detected PS had a short lifespan with the longest being 1100 ms (6.8 rotations). Exploration of the PS detection in a numerical model demonstrated that at least eight electrodes are required to avoid frequent false positive PS detection due to chance. Application of a detection grid consisting a double ring of electrodes (2 × 2 and 4 × 4 rings) decreased the number of false positive detections. The double ring was more resilient to electrode swapping (with just three instances of false positives versus 4380 false positives using 2 × 2 ring).CONCLUSIONS: The number of detected rotors critically depends upon the parameters of the detection algorithm, especially the number of electrodes used to detect PS. Based on our results, we recommend double ring comprised of 2 × 2 and 4 × 4 grid of electrodes for robust rotor detection.SIGNIFICANCE: Great methodological care has to be taken before equating detected PS with rotating waves and using PS detection algorithms to guide catheter ablation of AF.
KW - Algorithms
KW - Atrial Fibrillation/physiopathology
KW - Body Surface Potential Mapping/methods
KW - Catheter Ablation/methods
KW - Electrophysiologic Techniques, Cardiac/methods
KW - Humans
KW - Models, Cardiovascular
U2 - 10.1109/TBME.2016.2554660
DO - 10.1109/TBME.2016.2554660
M3 - SCORING: Journal article
C2 - 27101596
VL - 64
SP - 310
EP - 318
JO - IEEE T BIO-MED ENG
JF - IEEE T BIO-MED ENG
SN - 0018-9294
IS - 2
ER -