Overcoming Uncertainties in Electrogram-Based Atrial Fibrillation Mapping: A Review

Saha, Simanto; Linz, Dominik; Saha, Dyuti; McEwan, Alistair; Baumert, Mathias

doi:10.1007/s13239-023-00696-w

Cited by 1 publication

(1 citation statement)

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“…Since DF and RI indices describe solely the rhythmic properties of the activation process, they may be profitably complemented by techniques assessing wave morphology and fragmentation 51,55,56 . As well, information-based measurements may improve coupling estimation allowing propagation tracking through the assessment of causal links between sites 57,58 .…”

Section: Discussionmentioning

confidence: 99%

Systematic in-silico evaluation of fibrosis effects on re-entrant wave dynamics in atrial tissue

Masè,

Cristoforetti,

Pelloni

et al. 2024

Sci Rep

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Despite the key role of fibrosis in atrial fibrillation (AF), the effects of different spatial distributions and textures of fibrosis on wave propagation mechanisms in AF are not fully understood. To clarify these aspects, we performed a systematic computational study to assess fibrosis effects on the characteristics and stability of re-entrant waves in electrically-remodelled atrial tissues. A stochastic algorithm, which generated fibrotic distributions with controlled overall amount, average size, and orientation of fibrosis elements, was implemented on a monolayer spheric atrial model. 245 simulations were run at changing fibrosis parameters. The emerging propagation patterns were quantified in terms of rate, regularity, and coupling by frequency-domain analysis of correspondent synthetic bipolar electrograms. At the increase of fibrosis amount, the rate of reentrant waves significantly decreased and higher levels of regularity and coupling were observed (p < 0.0001). Higher spatial variability and pattern stochasticity over repetitions was observed for larger amount of fibrosis, especially in the presence of patchy and compact fibrosis. Overall, propagation slowing and organization led to higher stability of re-entrant waves. These results strengthen the evidence that the amount and spatial distribution of fibrosis concur in dictating re-entry dynamics in remodeled tissue and represent key factors in AF maintenance.

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