Velocity characteristics of atrial fibrillation sources determined by electrographic flow mapping before and after catheter ablation

Bellmann, Barbara; Zettwitz, Marit; Lin, Tina; Ruppersberg, Peter; Guttmann, Selma; Tscholl, Verena; Nagel, Patrick; Roser, Mattias; Landmesser, Ulf; Rillig, Andreas

doi:10.1016/j.ijcard.2019.02.006

Cited by 18 publications

(28 citation statements)

References 27 publications

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“…Electrographic flow (EGF) mapping has recently been introduced as a novel technology for the identification and characterization of AF sources in humans. Bellmann et al demonstrated that EGF is the first method to have the potential to identify active AF sources during AF ablation and to be able to discriminate these from passive rotational phenomena, thereby possibly allowing for improved guidance of the AF ablation procedure [65,66].…”

Section: Catheter Ablation Of Af Beyond Pvimentioning

confidence: 99%

Catheter Ablation of Atrial Fibrillation: State of the Art and Future Perspectives

Rottner

Bellmann²,

Lin

et al. 2020

Cardiol Ther

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Purpose of Review: Atrial fibrillation (AF), the most common sustained arrhythmia, is associated with high rates of morbidity and mortality. Maintenance of stable sinus rhythm (SR) is the intended treatment target in symptomatic patients, and catheter ablation aimed at isolating the pulmonary veins provides the most effective treatment option, supported by encouraging clinical outcome data. A variety of energy sources and devices have been developed and evaluated. In this review, we summarize the current state of the art of catheter ablation of AF and describe future perspectives. Recent Findings: Catheter ablation is a wellestablished treatment option for patients with Enhanced Digital Features To view enhanced digital features for this article go to https://doi.org/10.6084/ m9.figshare.11357912.

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Section: Catheter Ablation Of Af Beyond Pvimentioning

confidence: 99%

Catheter Ablation of Atrial Fibrillation: State of the Art and Future Perspectives

Rottner

Bellmann²,

Lin

et al. 2020

Cardiol Ther

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“…13 EGF mapping (Ablamap ® software, Ablacon, Wheat Ridge, CO) is an innovative method used to approximate cardiac action potential flow through the atrium that can detect AF sources in patients with persistent AF. 14,15 Unipolar EGMs recorded from a 64-electrode basket catheter over 1 minute are processed using the Ablamap ® software. The electrical potential profile between the electrode positions at a given point in time (i.e., snapshots of the electrical field for every sampled point in time) is estimated by a Green's function biharmonic spline fit assuming that the charge in the system is passively distributing according to minimal energy.…”

Section: Discussionmentioning

confidence: 99%

First-in-human demonstration of 18-month spatiotemporal stability of active atrial fibrillation source detected by electrographic flow mapping in persistent atrial fibrillation

Gagyi

Ruppersberg²,

Kong³

et al. 2021

HeartRhythm Case Reports

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…Optical mapping of human AF [50] and mapping studies at ablation [2,7,[15][16][17][18][19][20][21] provide evidence for spiral wave activity during human AF. Recent work has shown a significant correlation between high-resolution optical mapping of AF in human atria and clinical mapping [51].…”

Section: Mechanistic Implicationsmentioning

confidence: 95%

“…PVI has a success rate of 40-70%, which is higher than other therapies, but has been difficult to improve by additional ablation [14]. More recently, tip locations of spiral waves have been targeted by ablation [2,7,[15][16][17][18][19][20][21], resulting in mixed results [22,23] that may improve in subsets of patients treated by targeted ablation PVI [24].…”

Section: Introductionmentioning

confidence: 99%

Three dimensional reconstruction to visualize atrial fibrillation activation patterns on curved atrial geometry

et al. 2021

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Background The rotational activation created by spiral waves may be a mechanism for atrial fibrillation (AF), yet it is unclear how activation patterns obtained from endocardial baskets are influenced by the 3D geometric curvature of the atrium or ‘unfolding’ into 2D maps. We develop algorithms that can visualize spiral waves and their tip locations on curved atrial geometries. We use these algorithms to quantify differences in AF maps and spiral tip locations between 3D basket reconstructions, projection onto 3D anatomical shells and unfolded 2D surfaces. Methods We tested our algorithms in N = 20 patients in whom AF was recorded from 64-pole baskets (Abbott, CA). Phase maps were generated by non-proprietary software to identify the tips of spiral waves, indicated by phase singularities. The number and density of spiral tips were compared in patient-specific 3D shells constructed from the basket, as well as 3D maps from clinical electroanatomic mapping systems and 2D maps. Results Patients (59.4±12.7 yrs, 60% M) showed 1.7±0.8 phase singularities/patient, in whom ablation terminated AF in 11/20 patients (55%). There was no difference in the location of phase singularities, between 3D curved surfaces and 2D unfolded surfaces, with a median correlation coefficient between phase singularity density maps of 0.985 (0.978–0.990). No significant impact was noted by phase singularities location in more curved regions or relative to the basket location (p>0.1). Conclusions AF maps and phase singularities mapped by endocardial baskets are qualitatively and quantitatively similar whether calculated by 3D phase maps on patient-specific curved atrial geometries or in 2D. Phase maps on patient-specific geometries may be easier to interpret relative to critical structures for ablation planning.

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Velocity characteristics of atrial fibrillation sources determined by electrographic flow mapping before and after catheter ablation

Cited by 18 publications

References 27 publications

Catheter Ablation of Atrial Fibrillation: State of the Art and Future Perspectives

Catheter Ablation of Atrial Fibrillation: State of the Art and Future Perspectives

First-in-human demonstration of 18-month spatiotemporal stability of active atrial fibrillation source detected by electrographic flow mapping in persistent atrial fibrillation

Three dimensional reconstruction to visualize atrial fibrillation activation patterns on curved atrial geometry

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