Almeida, Tiago P.

Chu, Gavin S.

Dastagir, Nawshin

Ehnesh, Mahmoud

Li, Xin

Ng, G. André

Schlindwein, Fernando S.

Stafford, P. J.

English

KITopen

Correlation Between Rotors and Changes in Atrial FibrillationCycle Length in PersAFMahmoud Ehnesh1, Xin Li1,2,3, Tiago P. Almeida1,2, Gavin S. Chu2,3, Nawshin Dastagir4, P.J.Stafford2,3, G. André Ng2,3, and Fernando S. Schlindwein1,31School of Engineering, University of Leicester, Leicester, UK2Department of Cardiovascular Sciences, Glenfield Hospital, Leicester, UK3National Institute for Health Research Leicester Cardiovascular Biomedical Research Centre, Leicester, UK4University of Auckland, Auckland Bioengineering Institute, New ZealandBackgroundIdentifying ablation targets for persistent atrialfibrillation (PersAF) is still challenging despite at-tempts to guide ablation using Highest DominantFrequency (HDF) and rotors.ObjectiveThe objective is to investigate the spatial correla-tion between rotor sites and sites of Atrial Fibril-lation Cycle Length (AFCL) changes that lead toAF termination in PersAF.MethodsTen patients underwent a first time HDF-targetPersAF ablation in the left atrium (LA). LAwas mapped using non-contact array (Ensite, Ab-bott / St. Jude Medical). Virtual electro-grams (VEGMs) from 2048-channels (30 s dura-tion) were exported into MATLAB and QRST-subtraction was performed, then target HDF siteswere identified and ablated. LA AFCL was mea-sured pre- and post-ablation of each of the HDFsites. The pre- and post-ablation rotors sites andsites of AFCL changes during ablation were com-pared using spatial correlation, for terminated andnon-terminated patients.ResultsAF was terminated in 40% of enrolled patients.Although the results suggest poor spatial corre-lation between rotors sites and sites of AFCLchanges in terminated and non-terminated pa-tients, higher correlation was found in terminatedpatients (spatial overlapping percentage 25±4.2%Vs. 11±3.7%, respectively). Additionally, globalHDF decreased for terminated patients (pre:9.4±1.1 Hz Vs. post: 8.2±0.4 Hz, P < 0.001)and increased in non-terminated patients (pre:7.8±1.7 Hz Vs. post: 9.3±0.8 Hz). In terminatedpatients, LA ablation reduced the number of ro-tors (pre- Vs. post-ablation, 19±7.8 Vs. 4.2±0.2),rotor lifespan (9.6±0.09 ms Vs. 8.7±0.1 ms,P<0.001), rotor displacement (3.3±1.3 mm Vs.2.3±1.3 mm) and rotor velocity (2.8±0.9 mm/msVs. 1.4±0.8 mm/ms). Conversely, LA abla-tion increased the number of rotors (pre- Vs.post-ablation, 11±3.8 Vs. 22±8.2), rotor lifespan(7.7±0.11 ms Vs 8.4±0.1 ms, P<0.001) and rotorvelocity (0.9±0.7 mm/ms Vs. 1.3±0.5 mm/ms)in non-terminated patients, and reduced rotor dis-placement (3.5±1.4 mm Vs. 2.3±0.6 mm).DiscussionOur results have shown that using 30 s noncontactVEGMs rotors sites demonstrated poor simulta-neous spatial overlapping of the location of rotorsand sites of AFCL changes that lead to AF ter-mination suggesting that, if there is interactionbetween these 2 proxies of PersAF, the dynamicsof such interaction is more complex than a simplesimultaneous spatial correlation. The number ofrotors and rotors’ parameters did change followingHDF-target ablation in terminated patients.doi:10.5445/IR/1000138450 Atrial Signals 2021 Proceedings 4

Correlation Between Rotors and Changes in Atrial Fibrillation Cycle Length in PersAF. Abstract

https://publikationen.bibliothek.kit.edu/1000138450/130443067

Correlation Between Rotors and Changes in Atrial Fibrillation Cycle Length in PersAF. Abstract

Abstract

Similar works

Full text

Available Versions

KITopen