scholarly journals Noninvasive phase mapping of persistent atrial fibrillation in humans: Comparison with invasive catheter mapping

2017 ◽  
Vol 23 (4) ◽  
pp. e12527 ◽  
Author(s):  
Andreas Metzner ◽  
Erik Wissner ◽  
Alexey Tsyganov ◽  
Vitaly Kalinin ◽  
Michael Schlüter ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Persistent Atrial Fibrillation ◽  
Catheter Mapping ◽  
Phase Mapping

scholarly journals Endocardial-Epicardial Phase Mapping of Prolonged Persistent Atrial Fibrillation Recordings

2020 ◽  
Vol 13 (8) ◽  
Author(s):  
Ramanathan Parameswaran ◽  
Jonathan M. Kalman ◽  
Alistair Royse ◽  
John Goldblatt ◽  
Marco Larobina ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Persistent Atrial Fibrillation ◽  
Temporal Heterogeneity ◽  
Activation Patterns ◽  
3 Dimensional ◽  
Transmural Migration ◽  
Endocardial Mapping ◽  
Phase Mapping ◽  
Insight Into ◽  
Activation Mapping

Background: Endocardial-epicardial dissociation and focal breakthroughs in humans with atrial fibrillation (AF) have been recently demonstrated using activation mapping of short 10-second AF segments. In the current study, we used simultaneous endo-epi phase mapping to characterize endo-epi activation patterns on long segments of human persistent AF. Methods: Simultaneous intraoperative mapping of endo- and epicardial lateral right atrium wall was performed in patients with persistent AF using 2 high-density grid catheters (16 electrodes, 3 mm spacing). Filtered unipolar and bipolar electrograms of continuous 2-minute AF recordings and electrodes locations were exported for phase analyses. We defined endocardial-epicardial dissociation as phase difference of ≥20 ms between paired endo-epi electrodes. Wavefronts were classified as rotations, single wavefronts, focal waves, or disorganized activity as per standard criteria. Endo-Epi wavefront patterns were simultaneously compared on dynamic phase maps. Complex fractionated electrograms were defined as bipolar electrograms with ≥5 directional changes occupying at least 70% of sample duration. Results: Fourteen patients with persistent AF undergoing cardiac surgery were included. Endocardial-epicardial dissociation was seen in 50.3% of phase maps with significant temporal heterogeneity. Disorganized activity (Endo: 41.3% versus Epi: 46.8%, P =0.0194) and single wavefronts (Endo: 31.3% versus Epi: 28.1%, P =0.129) were the dominant patterns. Transient rotations (Endo: 22% versus Epi: 19.2%, P =0.169; mean duration: 590±140 ms) and nonsustained focal waves (Endo: 1.2% versus Epi: 1.6%, P =0.669) were also observed. Apparent transmural migration of rotational activations (n=6) from the epi- to the endocardium was seen in 2 patients. Electrogram fractionation was significantly higher in the epicardium than endocardium (61.2% versus 51.6%, P <0.0001). Conclusions: Simultaneous endo-epi phase mapping of prolonged human persistent AF recordings shows significant Endocardial-epicardial dissociation marked temporal heterogeneity, discordant and transitioning wavefronts patterns and complex fractionations. No sustained focal activity was observed. Such complex 3-dimensional interactions provide insight into why endocardial mapping alone may not fully characterize the AF mechanism and why endocardial ablation may not be sufficient. Graphic Abstract: A graphic abstract is available for this article.

scholarly journals Transient Rotor Activity During Prolonged 3-Dimensional Phase Mapping in Human Persistent Atrial Fibrillation

2018 ◽  
Vol 4 (1) ◽  
pp. 72-83 ◽  
Author(s):  
Bhupesh Pathik ◽  
Jonathan M. Kalman ◽  
Tomos Walters ◽  
Pawel Kuklik ◽  
Jichao Zhao ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Persistent Atrial Fibrillation ◽  
3 Dimensional ◽  
Phase Mapping

Absence of rotational activity detected using 2-dimensional phase mapping in the corresponding 3-dimensional phase maps in human persistent atrial fibrillation

Heart Rhythm ◽  
2018 ◽  
Vol 15 (2) ◽  
pp. 182-192 ◽  
Author(s):  
Bhupesh Pathik ◽  
Jonathan M. Kalman ◽  
Tomos Walters ◽  
Pawel Kuklik ◽  
Jichao Zhao ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Persistent Atrial Fibrillation ◽  
3 Dimensional ◽  
Phase Mapping

scholarly journals Transient Rotor Activity Using Novel Prolonged 3D Phase Mapping in Human Persistent Atrial Fibrillation

2017 ◽  
Vol 26 ◽  
pp. S175
Author(s):  
B. Pathik ◽  
J. Kalman ◽  
T. Walters ◽  
P. Kuklik ◽  
J. Zhao ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Persistent Atrial Fibrillation ◽  
Phase Mapping
Sign in / Sign up

Export Citation Format

Share Document