Spatiotemporal characterization of atrial activation in persistent human atrial fibrillation: Multisite electrogram analysis and surface electrocardiographic correlations—A pilot study

Dibs, Samer; Ng, Jason; Arora, Rishi; Passman, Rod; Kadish, Alan H.; Goldberger, Jeffrey J.

doi:10.1016/j.hrthm.2008.01.027

Cited by 46 publications

(39 citation statements)

References 40 publications

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“…The regularity index (RI), defined as the repetitiveness over time of the morphology of the detected activation waves (28), was used to quantify rotor cyclicity. The RI strongly correlated with DF (Supplemental Figure 5), implying that the most stable rotors were also the most regular rotors, which has been observed in patients with persistent AF (29). In 20% of F1759A-dTG hearts with AF, however, rotational circuits were not observed, although the optical mapping was limited to a single surface.…”

Section: Resultsmentioning

confidence: 64%

Aberrant sodium influx causes cardiomyopathy and atrial fibrillation in mice

Wan¹,

Abrams²,

Weinberg³

et al. 2015

Journal of Clinical Investigation

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Section: Resultsmentioning

confidence: 64%

Aberrant sodium influx causes cardiomyopathy and atrial fibrillation in mice

Wan¹,

Abrams²,

Weinberg³

et al. 2015

Journal of Clinical Investigation

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“…13,25 In the present study, we did not use DF for targeting ablation. However, 2 studies to date have assessed the effect of prospective ablation at such sites, with differing results.…”

Section: Is a Frequency-map-guided Ablation Strategy Rational?mentioning

confidence: 90%

Spatiotemporal Behavior of High Dominant Frequency During Paroxysmal and Persistent Atrial Fibrillation in the Human Left Atrium

Jarman

Wong

Kojodjojo

et al. 2012

Circ: Arrhythmia and Electrophysiology

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Background-Sites of high dominant frequency (DF peak ) are thought to indicate the location of drivers of atrial fibrillation (AF), but characterization of their spatiotemporal distribution and stability, critical to their relevance as targets for catheter ablation, requires simultaneous global mapping of the left atrium. Methods and Results-Noncontact electrograms recorded simultaneously from 256 left atrial sites during spontaneous AF were analyzed. After subtraction of the ventricular component, fast Fourier transform identified the DF at each site. Focal areas of DF peak were defined as those having a DF >20% above all neighboring sites. Twenty-four patients with spontaneous AF (11 paroxysmal and 13 persistent) were studied. In paroxysmal AF, sites of DF peak (mean DF, 11.6±2.9 Hz) were observed in 100% of patients (present during 65% of the mapping period). In contrast, DF peak was detected in only 31% of patients with persistent AF (P<0.001) and for only 5% of the mapping period (P<0.001). In both groups, locations of DF peak varied widely in both consecutive and separated segments of AF (κ coefficient range, -0.07-0.22). Activation sequences around sites of DF peak did not demonstrate centrifugal activation that would be expected from focal drivers. Conclusions-Focal areas of high DF are more frequent in paroxysmal than persistent AF, are spatiotemporally unstable, are not the source of centrifugal activation, and are not, therefore, indicative of fixed drivers of AF. In the absence of spatiotemporal stability, the success of ablation at sites of DF peak cannot be explained by elimination of fixed drivers.(Circ Arrhythm Electrophysiol. 2012;5:650-658.)

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“…21 The general acceptance of the existence of high-frequency sources responsible for the maintenance of AF motivated more recent studies to investigate whether distinct frequencies present in RA and LA could be identified on surface ECG recordings. Dibs et al 22 studied the reflection of atrial frequencies obtained sequentially from multiple sites in both atria and the standard ECG. Although they reported a good correspondence between mean RA frequencies with lead V 2 and LA frequencies with lead V 6 , extrapolation of these results is hampered by the little differences found between mean frequencies from RA and LA.…”

Section: Discussionmentioning

confidence: 99%

Noninvasive Localization of Maximal Frequency Sites of Atrial Fibrillation by Body Surface Potential Mapping

Guillem

Climent

Millet

et al. 2013

Circ: Arrhythmia and Electrophysiology

109

130

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Background Ablation of high-frequency sources in patients with atrial fibrillation (AF) is an effective therapy to restore sinus rhythm. However, this strategy may be ineffective in patients without a significant dominant frequency (DF) gradient. The aim of this study was to investigate whether sites with high-frequency activity in human AF can be identified noninvasively, which should help intervention planning and therapy. Methods and Results In 14 patients with a history of AF, 67-lead body surface recordings were simultaneously registered with 15 endocardial electrograms from both atria including the highest DF site, which was predetermined by atrial-wide real-time frequency electroanatomical mapping. Power spectra of surface leads and the body surface location of the highest DF site were compared with intracardiac information. Highest DFs found on specific sites of the torso showed a significant correlation with DFs found in the nearest atrium (ρ=0.96 for right atrium and ρ=0.92 for left atrium) and the DF gradient between them (ρ=0.93). The spatial distribution of power on the surface showed an inverse relationship between the frequencies versus the power spread area, consistent with localized fast sources as the AF mechanism with fibrillatory conduction elsewhere. Conclusions Spectral analysis of body surface recordings during AF allows a noninvasive characterization of the global distribution of the atrial DFs and the identification of the atrium with the highest frequency, opening the possibility for improved noninvasive personalized diagnosis and treatment.

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Spatiotemporal characterization of atrial activation in persistent human atrial fibrillation: Multisite electrogram analysis and surface electrocardiographic correlations—A pilot study

Cited by 46 publications

References 40 publications

Aberrant sodium influx causes cardiomyopathy and atrial fibrillation in mice

Aberrant sodium influx causes cardiomyopathy and atrial fibrillation in mice

Spatiotemporal Behavior of High Dominant Frequency During Paroxysmal and Persistent Atrial Fibrillation in the Human Left Atrium

Noninvasive Localization of Maximal Frequency Sites of Atrial Fibrillation by Body Surface Potential Mapping

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