Non-invasive location of re-entrant propagation patterns during atrial fibrillation

Autores UPV
Año
CONGRESO Non-invasive location of re-entrant propagation patterns during atrial fibrillation

Abstract

Abstract. Reentrant drivers or mother rotors have been defined as a mechanism responsible of atrial fibrillation (AF) maintenance whose ablation can terminate the fibrillatory episodes. These re-entrant patterns can be identified in the atrial wall by detecting phase singularities (PS) in the epicardial phase maps. In this study, we evaluate the potential role of body surface phase maps to non-invasively locate atrial sites that may harbor rotors. High-density surface potential recordings were obtained from 14 AF patients and singularity points (SP) were located in the torso phase maps after band-pass filtering at the highest dominant frequency. Stable SPs were found during 73.1±16.8% of time after band-pass filtering vs. 8.3±5.7% on raw signals. Sur-face SPs representing atrial rotors were detected at specific torso areas related with their atrial location. Besides, in the present study we made use of mathematical models of atrial ac-tivity to evaluate the representation of SP on the torso and inside the passive volume between heart and torso. We simulated two propagation patterns led by mother rotors and the projection of this atrial activity on the virtual torso. Out results showed that even for small rotors in the atria, the reentrant patterns can be detected on the torso by filtering at the highest dominant frequency. These results show that the electrical propagation pattern in the atria during AF is reflected in the electrocardiogram. Our simulations demonstrated that rotors that remained stable on the epicardium can be detected noninvasively. Phase analysis after band-pass filtering can detect atrial drivers, helping to plan the best therapy strategies.