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Noninvasive Estimation of Epicardial Dominant High‐Frequency Regions During Atrial Fibrillation
Author(s) -
PEDRÓNTORRECILLA JORGE,
RODRIGO MIGUEL,
CLIMENT ANDREU M.,
LIBEROS ALEJANDRO,
PÉREZDAVID ESTHER,
BERMEJO JAVIER,
ARENAL ÁNGEL,
MILLET JOSÉ,
FERNÁNDEZAVILÉS FRANCISCO,
BERENFELD OMER,
ATIENZA FELIPE,
GUILLEM MARÍA S.
Publication year - 2016
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.12931
Subject(s) - torso , intracardiac injection , medicine , electrocardiography , atrial fibrillation , ablation , cardiology , inverse problem , mathematics , mathematical analysis , anatomy
Noninvasive Estimation of Fibrillation Frequencies Introduction Ablation of high dominant frequency (DF) sources in patients with atrial fibrillation (AF) is an effective treatment option for paroxysmal AF. The aim of this study was to evaluate the accuracy of noninvasive estimation of DF and electrical patterns determination by solving the inverse problem of the electrocardiography. Methods Four representative AF patients with left‐to‐right and right‐to‐left atrial DF patterns were included in the study. For each patient, intracardiac electrograms from both atria were recorded simultaneously together with 67‐lead body surface recordings. In addition to clinical recordings, realistic mathematical models of atria and torso anatomy with different DF patterns of AF were used. For both mathematical models and clinical recordings, inverse‐computed electrograms were compared to intracardiac electrograms in terms of voltage, phase, and frequency spectrum relative errors. Results Comparison between intracardiac and inverse computed electrograms for AF patients showed 8.8 ± 4.4% errors for DF, 32 ± 4% for voltage, and 65 ± 4% for phase determination. These results were corroborated by mathematical simulations showing that the inverse problem solution was able to reconstruct the frequency spectrum and the DF maps with relative errors of 5.5 ± 4.1%, whereas the reconstruction of the electrograms or the instantaneous phase presented larger relative errors (i.e., 38 ± 15% and 48 ± 14 % respectively, P < 0.01). Conclusions Noninvasive reconstruction of atrial frequency maps can be achieved by solving the inverse problem of electrocardiography with a higher accuracy than temporal distribution patterns.