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Characterization of Electrograms from Multipolar Diagnostic Catheters during Atrial Fibrillation.

Ganesan P, Cherry EM, Pertsov AM, Ghoraani B - Biomed Res Int (2015)

Bottom Line: However, it remains unclear how to effectively utilize the information provided by the MPDC to locate the AF-sustaining sites, known as sustained rotor-like activities (RotAs).In this study, we use computer modeling to investigate the variations in the characteristics of the MPDC electrograms, namely, total conduction delay (TCD) and average cycle length (CL), as the MPDC moves towards a RotA source.Subsequently, a study with a human subject was performed in order to verify the predictions of the simulation study.

View Article: PubMed Central - PubMed

Affiliation: Biomedical Engineering Department, Rochester Institute of Technology, Rochester, NY 14623, USA.

ABSTRACT
Atrial fibrillation (AF) is the most common arrhythmia in USA with more than 2.3 million people affected annually. Catheter ablation procedure is a method for treatment of AF, which involves 3D electroanatomic mapping of the patient's left atrium (LA) by maneuvering a conventional multipolar diagnostic catheter (MPDC) along the LA endocardial surface after which pulmonary vein (PV) isolation is performed, thus eliminating the AF triggers originating from the PVs. However, it remains unclear how to effectively utilize the information provided by the MPDC to locate the AF-sustaining sites, known as sustained rotor-like activities (RotAs). In this study, we use computer modeling to investigate the variations in the characteristics of the MPDC electrograms, namely, total conduction delay (TCD) and average cycle length (CL), as the MPDC moves towards a RotA source. Subsequently, a study with a human subject was performed in order to verify the predictions of the simulation study. The conclusions from this study may be used to iteratively direct an MPDC towards RotA sources thus allowing the RotAs to be localized for customized and improved AF ablation.

No MeSH data available.


Related in: MedlinePlus

This diagram illustrates the FAB and TCD calculations for the electrograms recorded using an MPDC. Bipole 6 is the FAB and TCD is 94 ms, which is the sum of CD1 to CD10. AT: activation time. CD: conduction delay. All times are given in ms.
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fig2: This diagram illustrates the FAB and TCD calculations for the electrograms recorded using an MPDC. Bipole 6 is the FAB and TCD is 94 ms, which is the sum of CD1 to CD10. AT: activation time. CD: conduction delay. All times are given in ms.

Mentions: The conduction delay (CD) of a particular bipole is calculated as the interval from each local activation to that of the neighboring bipole with respect to its FAB. For example, in Figure 1(b), the conduction delay of bipole 5 (CD5) is calculated as the time interval between the activations of bipole 6 (i.e., FAB) and bipole 5, as illustrated in the figure. CD4 will be calculated with respect to bipole 5 and so forth as follows:(1)CDi=ATi−ATi+1i=FAB−1 to  1.The calculation of CD6 to CD9 will be continued with respect to the subsequent bipole as shown as follows:(2)CDi=ATi+1−ATii=FAB to  9.Additionally, CD10 is calculated as the time interval between bipole 1 and bipole 10 as given as follows:(3)CD10=AT1−AT10.Figure 2 illustrates how our CD and TCD calculations are performed for the MPDC in Figure 1(b). Bipole 6 is the FAB with the earliest activated time of 580 ms. CD1 to CD10 are calculated as explained above and shown for each bipole. This procedure is continued for all cycles of the electrogram and the CD for every bipole electrode is averaged over the number of cycles to obtain a single value of CD for each electrode. Finally, the summation of the average CD of every electrode is calculated to obtain the TCD at each recording site. The mathematical expression for TCD at any MPDC location l is given by(4)TCDl=∑i=110CDi.


Characterization of Electrograms from Multipolar Diagnostic Catheters during Atrial Fibrillation.

Ganesan P, Cherry EM, Pertsov AM, Ghoraani B - Biomed Res Int (2015)

This diagram illustrates the FAB and TCD calculations for the electrograms recorded using an MPDC. Bipole 6 is the FAB and TCD is 94 ms, which is the sum of CD1 to CD10. AT: activation time. CD: conduction delay. All times are given in ms.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4637153&req=5

fig2: This diagram illustrates the FAB and TCD calculations for the electrograms recorded using an MPDC. Bipole 6 is the FAB and TCD is 94 ms, which is the sum of CD1 to CD10. AT: activation time. CD: conduction delay. All times are given in ms.
Mentions: The conduction delay (CD) of a particular bipole is calculated as the interval from each local activation to that of the neighboring bipole with respect to its FAB. For example, in Figure 1(b), the conduction delay of bipole 5 (CD5) is calculated as the time interval between the activations of bipole 6 (i.e., FAB) and bipole 5, as illustrated in the figure. CD4 will be calculated with respect to bipole 5 and so forth as follows:(1)CDi=ATi−ATi+1i=FAB−1 to  1.The calculation of CD6 to CD9 will be continued with respect to the subsequent bipole as shown as follows:(2)CDi=ATi+1−ATii=FAB to  9.Additionally, CD10 is calculated as the time interval between bipole 1 and bipole 10 as given as follows:(3)CD10=AT1−AT10.Figure 2 illustrates how our CD and TCD calculations are performed for the MPDC in Figure 1(b). Bipole 6 is the FAB with the earliest activated time of 580 ms. CD1 to CD10 are calculated as explained above and shown for each bipole. This procedure is continued for all cycles of the electrogram and the CD for every bipole electrode is averaged over the number of cycles to obtain a single value of CD for each electrode. Finally, the summation of the average CD of every electrode is calculated to obtain the TCD at each recording site. The mathematical expression for TCD at any MPDC location l is given by(4)TCDl=∑i=110CDi.

Bottom Line: However, it remains unclear how to effectively utilize the information provided by the MPDC to locate the AF-sustaining sites, known as sustained rotor-like activities (RotAs).In this study, we use computer modeling to investigate the variations in the characteristics of the MPDC electrograms, namely, total conduction delay (TCD) and average cycle length (CL), as the MPDC moves towards a RotA source.Subsequently, a study with a human subject was performed in order to verify the predictions of the simulation study.

View Article: PubMed Central - PubMed

Affiliation: Biomedical Engineering Department, Rochester Institute of Technology, Rochester, NY 14623, USA.

ABSTRACT
Atrial fibrillation (AF) is the most common arrhythmia in USA with more than 2.3 million people affected annually. Catheter ablation procedure is a method for treatment of AF, which involves 3D electroanatomic mapping of the patient's left atrium (LA) by maneuvering a conventional multipolar diagnostic catheter (MPDC) along the LA endocardial surface after which pulmonary vein (PV) isolation is performed, thus eliminating the AF triggers originating from the PVs. However, it remains unclear how to effectively utilize the information provided by the MPDC to locate the AF-sustaining sites, known as sustained rotor-like activities (RotAs). In this study, we use computer modeling to investigate the variations in the characteristics of the MPDC electrograms, namely, total conduction delay (TCD) and average cycle length (CL), as the MPDC moves towards a RotA source. Subsequently, a study with a human subject was performed in order to verify the predictions of the simulation study. The conclusions from this study may be used to iteratively direct an MPDC towards RotA sources thus allowing the RotAs to be localized for customized and improved AF ablation.

No MeSH data available.


Related in: MedlinePlus