A Novel Tool for the Identification and Characterization of Repetitive Patterns in High-Density Contact Mapping of Atrial Fibrillation

Zeemering, Stef; Hunnik, Arne van; Rosmalen, Frank van; Bonizzi, Pietro; Scaf, Billy; Delhaas, Tammo; Verheule, Sander; Schotten, Ulrich

doi:10.3389/fphys.2020.570118

Cited by 20 publications

(21 citation statements)

References 45 publications

(49 reference statements)

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“…We further acknowledge that not all researchers in the field agree with the notion of phase transformation and the study of phase singularity dynamics in AF ( Podziemski et al, 2018 ). We also note that in the electrogram-based component of the current study that sinusoidal recomposition was used for phase reconstruction, and recognize that other approaches such as linear interpolation of phase between activation times in the unipolar electrogram have been suggested as important alternative approaches to phase recomposition ( Zeemering et al, 2020 ). Although this approach was not utilized in this current investigation, we would anticipate it could also potentially lead to PS dynamics that could be modeled with an M/M/infinity process, as we found that M/M/infinity approaches were effective in the optically mapped and simulated AF data where transmembrane voltage was able to be directly ascertained.…”

Section: Discussionmentioning

confidence: 89%

M/M/Infinity Birth-Death Processes – A Quantitative Representational Framework to Summarize and Explain Phase Singularity and Wavelet Dynamics in Atrial Fibrillation

et al. 2021

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RationaleA quantitative framework to summarize and explain the quasi-stationary population dynamics of unstable phase singularities (PS) and wavelets in human atrial fibrillation (AF) is at present lacking. Building on recent evidence showing that the formation and destruction of PS and wavelets in AF can be represented as renewal processes, we sought to establish such a quantitative framework, which could also potentially provide insight into the mechanisms of spontaneous AF termination.ObjectivesHere, we hypothesized that the observed number of PS or wavelets in AF could be governed by a common set of renewal rate constants λf (for PS or wavelet formation) and λd (PS or wavelet destruction), with steady-state population dynamics modeled as an M/M/∞ birth–death process. We further hypothesized that changes to the M/M/∞ birth–death matrix would explain spontaneous AF termination.Methods and ResultsAF was studied in in a multimodality, multispecies study in humans, animal experimental models (rats and sheep) and Ramirez-Nattel-Courtemanche model computer simulations. We demonstrated: (i) that λf and λd can be combined in a Markov M/M/∞ process to accurately model the observed average number and population distribution of PS and wavelets in all systems at different scales of mapping; and (ii) that slowing of the rate constants λf and λd is associated with slower mixing rates of the M/M/∞ birth–death matrix, providing an explanation for spontaneous AF termination.ConclusionM/M/∞ birth–death processes provide an accurate quantitative representational architecture to characterize PS and wavelet population dynamics in AF, by providing governing equations to understand the regeneration of PS and wavelets during sustained AF, as well as providing insight into the mechanism of spontaneous AF termination.

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Section: Discussionmentioning

confidence: 89%

M/M/Infinity Birth-Death Processes – A Quantitative Representational Framework to Summarize and Explain Phase Singularity and Wavelet Dynamics in Atrial Fibrillation

et al. 2021

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“…Atrial propagation patterns during atrial fibrillation (AF) can be characterize by a certain degree of recurrence [1][2][3][4][5][6], which can be associated with different types of reentrant circuits that can drive the arrhythmia. The investigation of how well this dynamic behavior of atrial activity (AA) propagation patterns during AF can be noninvasively characterized by analyzing ECG signals is relevant in order to improve AF patient stratification and treatment selection, without resorting to invasive analysis.…”

Section: Introductionmentioning

confidence: 99%

Body-Surface Atrial Vector Similarity as a New Way to Investigate Atrial Fibrillation Propagation Dynamics

Bonizzi

Zeemering

Karel

et al. 2021

2021 Computing in Cardiology (CinC)

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Atrial propagation patterns during atrial fibrillation (AF) can be characterized by a certain degree of recurrence (associated with different types of reentrant circuits that can drive the arrhythmia). In this study, we investigated this recurrent activity at the level of the bodysurface, by measuring the level of similarity between pairs of consecutive atrial vectors. High-density body surface potential maps (120 anterior, 64 posterior electrodes) were recorded in 75 patients in persistent AF. For each patient, atrial vectors were created by taking the samples from all electrodes at each time instant. Similarity between consecutive vectors was measured in terms of the value of the cosine of the angle between two vectors. In all patients, the series of cosine values showed a quasi-periodic behavior, with atrial vectors alternating between phases of slow motion, and phases of fast motion. Moreover, the frequency of this behavior is about twice the AF dominant frequency, which suggests that within one AF cycle there are two phases of slow motion and two of fast motion, alternating. Finally, the amount of slow phases is positively correlated with a higher long-term recurrent behavior of the atrial propagation patterns. This seems to indicate that atrial vectors may provide a new way to noninvasively investigate atrial fibrillation dynamics.

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“…RBF interpolation does not require any assumptions on the spacing and/or density of the interpolation points (Fornefett et al, 2001;Kybic et al, 2002a,b). This allows integration with different clinically available mapping systems, with respect to other approaches (Rogers et al, 1997;Bayly et al, 1998;Alcaine et al, 2014;Zeemering et al, 2020) proposed in the experimental setting, which instead require regularly spaced and/or high-density latency data. In this study we demonstrated the capability of RBFs to accurately reconstruct CV fields from the analysis of simultaneous electrograms from multipolar catheters and we showed that the application of operators, such as the divergence, to the calculated CV fields could be used to identify focal drivers in the presence of complex propagation patterns.…”

Section: Radial Basis Function-based Conduction Velocity Vector Approach For the Characterization Of Propagation Patternsmentioning

confidence: 99%

A Divergence-Based Approach for the Identification of Atrial Fibrillation Focal Drivers From Multipolar Mapping: A Computational Study

et al. 2021

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The expanding role of catheter ablation of atrial fibrillation (AF) has stimulated the development of novel mapping strategies to guide the procedure. We introduce a novel approach to characterize wave propagation and identify AF focal drivers from multipolar mapping data. The method reconstructs continuous activation patterns in the mapping area by a radial basis function (RBF) interpolation of multisite activation time series. Velocity vector fields are analytically determined, and the vector field divergence is used as a marker of focal drivers. The method was validated in a tissue patch cellular automaton model and in an anatomically realistic left atrial (LA) model with Courtemanche–Ramirez–Nattel ionic dynamics. Divergence analysis was effective in identifying focal drivers in a complex simulated AF pattern. Localization was reliable even with consistent reduction (47%) in the number of mapping points and in the presence of activation time misdetections (noise <10% of the cycle length). Proof-of-concept application of the method to human AF mapping data showed that divergence analysis consistently detected focal activation in the pulmonary veins and LA appendage area. These results suggest the potential of divergence analysis in combination with multipolar mapping to identify AF critical sites. Further studies on large clinical datasets may help to assess the clinical feasibility and benefit of divergence analysis for the optimization of ablation treatment.

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A Novel Tool for the Identification and Characterization of Repetitive Patterns in High-Density Contact Mapping of Atrial Fibrillation

Cited by 20 publications

References 45 publications

M/M/Infinity Birth-Death Processes – A Quantitative Representational Framework to Summarize and Explain Phase Singularity and Wavelet Dynamics in Atrial Fibrillation

M/M/Infinity Birth-Death Processes – A Quantitative Representational Framework to Summarize and Explain Phase Singularity and Wavelet Dynamics in Atrial Fibrillation

Body-Surface Atrial Vector Similarity as a New Way to Investigate Atrial Fibrillation Propagation Dynamics

A Divergence-Based Approach for the Identification of Atrial Fibrillation Focal Drivers From Multipolar Mapping: A Computational Study

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