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Spatial resolution requirements for accurate identification of drivers of atrial fibrillation

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Title: Spatial resolution requirements for accurate identification of drivers of atrial fibrillation
Authors: Roney, CH
Cantwell, CD
Bayer, JD
Qureshi, NA
Lim, PB
Tweedy, JH
Kanagaratnam, P
Peters, NS
Vigmond, EJ
Ng, F
Item Type: Journal Article
Abstract: Background—Recent studies have demonstrated conflicting mechanisms underlying atrial fibrillation (AF), with the spatial resolution of data often cited as a potential reason for the disagreement. The purpose of this study was to investigate whether the variation in spatial resolution of mapping may lead to misinterpretation of the underlying mechanism in persistent AF. Methods and Results—Simulations of rotors and focal sources were performed to estimate the minimum number of recording points required to correctly identify the underlying AF mechanism. The effects of different data types (action potentials and unipolar or bipolar electrograms) and rotor stability on resolution requirements were investigated. We also determined the ability of clinically used endocardial catheters to identify AF mechanisms using clinically recorded and simulated data. The spatial resolution required for correct identification of rotors and focal sources is a linear function of spatial wavelength (the distance between wavefronts) of the arrhythmia. Rotor localization errors are larger for electrogram data than for action potential data. Stationary rotors are more reliably identified compared with meandering trajectories, for any given spatial resolution. All clinical high-resolution multipolar catheters are of sufficient resolution to accurately detect and track rotors when placed over the rotor core although the low-resolution basket catheter is prone to false detections and may incorrectly identify rotors that are not present. Conclusions—The spatial resolution of AF data can significantly affect the interpretation of the underlying AF mechanism. Therefore, the interpretation of human AF data must be taken in the context of the spatial resolution of the recordings.
Issue Date: 12-May-2017
Date of Acceptance: 11-Apr-2017
URI: http://hdl.handle.net/10044/1/48043
DOI: 10.1161/CIRCEP.116.004899
ISSN: 1941-3084
Publisher: American Heart Association
Start Page: 1
End Page: 13
Journal / Book Title: Circulation-Arrhythmia and Electrophysiology
Volume: 10
Issue: 5
Copyright Statement: © 2017 The Authors. Circulation: Arrhythmia and Electrophysiology is published on behalf of the American Heart Association, Inc., by Wolters Kluwer Health, Inc. This is an open access article under the terms of the Creative Commons Attribution Non-Commercial-NoDerivs License, which permits use, distribution, and reproduction in any medium, provided that the original work is properly cited, the use is noncommercial, and no modifications or adaptations are made.
Sponsor/Funder: British Heart Foundation
British Heart Foundation
Rosetrees Trust
British Heart Foundation
Medical Research Council (MRC)
Funder's Grant Number: RE/08/002/23906
RG/16/3/32175
A1173/ M577
FS/11/22/28745
MC_PC_12015
Keywords: Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Cardiovascular System & Cardiology
ablation techniques
arrhythmias
cardiac
atrial fibrillation
computational modeling
reentry
rotor
VELOCITY VECTOR-FIELDS
ROTOR MODULATION
FOCAL IMPULSE
CONVENTIONAL ABLATION
DOMINANT FREQUENCY
PERSISTENT
MODEL
ELIMINATION
MECHANISMS
INSIGHTS
ablation techniques
arrhythmias, cardiac
atrial fibrillation
computational modeling
reentry
rotor
Action Potentials
Atrial Fibrillation
Cardiac Catheterization
Cardiac Catheters
Electrocardiography
Electrophysiologic Techniques, Cardiac
Equipment Design
Heart Conduction System
Heart Rate
Humans
Models, Cardiovascular
Patient-Specific Modeling
Predictive Value of Tests
Reproducibility of Results
Signal Processing, Computer-Assisted
Time Factors
Heart Conduction System
Humans
Atrial Fibrillation
Electrocardiography
Electrophysiologic Techniques, Cardiac
Reproducibility of Results
Predictive Value of Tests
Equipment Design
Action Potentials
Heart Rate
Models, Cardiovascular
Time Factors
Signal Processing, Computer-Assisted
Cardiac Catheterization
Cardiac Catheters
Patient-Specific Modeling
Cardiovascular System & Hematology
1102 Cardiorespiratory Medicine and Haematology
1103 Clinical Sciences
1116 Medical Physiology
Publication Status: Published
Article Number: e004899
Online Publication Date: 2017-05-12
Appears in Collections:Faculty of Engineering
Bioengineering
National Heart and Lung Institute
Aeronautics
Faculty of Medicine