A New Efficient Method for Detecting Phase Singularity in Cardiac Fibrillation

Lee, Young-Seon; Song, Jun Hwan; Hwang, Minki; Lim, Byounghyun; Joung, Boyoung; Pak, Hui Nam

doi:10.1371/journal.pone.0167567

Cited by 12 publications

(12 citation statements)

References 46 publications

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“…A PS trajectory map on the atrial surface was also generated. The PS was defined at the point where the phase was undetermined 20,21 . We sampled the 6-s data for a single PS calculation in our previous study 7 .…”

Section: Definition Of Base Electrophysiological Parameters Of Fibrotmentioning

confidence: 99%

“…We sampled the 6-s data for a single PS calculation in our previous study 7 . We then used the location-centric method 21 that we previously developed for identifying the phase singularity points with a high computational speed and accuracy. We previously validated our method by comparing it with the Iyer-Gray method.…”

Section: Definition Of Base Electrophysiological Parameters Of Fibrotmentioning

confidence: 99%

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In situ procedure for high-efficiency computational modeling of atrial fibrillation reflecting personal anatomy, fiber orientation, fibrosis, and electrophysiology

Lim

Kim

Hwang

et al. 2020

Sci Rep

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We previously reported the feasibility and efficacy of a simulation-guided clinical catheter ablation of atrial fibrillation (AF) in an in-silico AF model. We developed a highly efficient realistic AF model reflecting the patient endocardial voltage and local conduction and tested its clinical feasibility. We acquired > 500 endocardial bipolar electrograms during right atrial pacing at the beginning of the AF ablation procedures. Based on the clinical bipolar electrograms, we generated simulated voltage maps by applying fibrosis and local activation maps adjusted for the fiber orientation. The software's accuracy (CUVIA2.5) was retrospectively tested in 17 patients and feasibility prospectively in 10 during clinical AF ablation. Results: We found excellent correlations between the clinical and simulated voltage maps (R = 0.933, p < 0.001) and clinical and virtual local conduction (R = 0.958, p < 0.001). The proportion of virtual local fibrosis was 15.4, 22.2, and 36.9% in the paroxysmal AF, persistent AF, and post-pulmonary vein isolation (PVI) states, respectively. The reconstructed virtual bipolar electrogram exhibited a relatively good similarities of morphology to the local clinical bipolar electrogram (R = 0.60 ± 0.08, p < 0.001). Feasibility testing revealed an in situ procedural computing time from the clinical data acquisition to wave-dynamics analyses of 48.2 ± 4.9 min. All virtual analyses were successfully achieved during clinical PVI procedures. We developed a highly efficient, realistic, in situ procedural simulation model reflective of individual anatomy, fiber orientation, fibrosis, and electrophysiology that can be applied during AF ablation. Catheter ablation (CA) is an effective approach for rhythm control management of atrial fibrillation (AF) 1,2. However, the recurrence rate after AF ablation procedures is still substantial 3. Although pulmonary vein isolation (PVI) is a well-established target of AF ablation, extra-pulmonary vein (PV) foci or drivers maintain AF in some patients, and extra-PV foci are more commonly found in AF patients with significant left atrial (LA) remodeling 4,5. The Substrate and Trigger Ablation for Reduction of Atrial Fibrillation trial part 2 (STAR AF2) demonstrated that an empirical extra-PV ablation did not improve the rhythm outcome compared with a circumferential PVI alone in patients with persistent AF (PeAF) 6. However, the one-year recurrence rate was higher than 40% regardless of any additional extra-PV ablation after the PVI, and the outcome of the invasive interventional catheter procedure was not adequate. Therefore, an innovative mapping technology to identify the core target of AF is needed in AF catheter ablation (AFCA). Simulation is a very useful computer-aided method for identifying appropriate intervention targets. We recently reported the feasibility of a simulation-guided PeAF ablation by applying a personalized heart computed tomography (CT) image-integrated AF simulation 7,8. To further this method, we developed a more realistic AF simulation r...

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Section: Definition Of Base Electrophysiological Parameters Of Fibrotmentioning

confidence: 99%

Section: Definition Of Base Electrophysiological Parameters Of Fibrotmentioning

confidence: 99%

In situ procedure for high-efficiency computational modeling of atrial fibrillation reflecting personal anatomy, fiber orientation, fibrosis, and electrophysiology

Lim

Kim

Hwang

et al. 2020

Sci Rep

Self Cite

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“…One of reasons why these interpretations of stimulation effect have not been integrated until today is the difficulty in objectively identifying the SW and its trajectory in the complex transition of excitation pattern that is observed just after stimulation. In 1998, Gray and colleagues (13,33) revealed that a complex SW can be analyzed by defining the center of the SW as a phase singularity (PS) in the phase map. However, quantitative tracking of the center of the SW is not available even by using the mathematical definition of PS (13,33).…”

Section: Introductionmentioning

confidence: 99%

“…In 1998, Gray and colleagues (13,33) revealed that a complex SW can be analyzed by defining the center of the SW as a phase singularity (PS) in the phase map. However, quantitative tracking of the center of the SW is not available even by using the mathematical definition of PS (13,33). Therefore, the quantitative analysis of the interaction process of shock-induced PSs and the original PS has not been reported and the action mechanism of stimulation has not yet been fully clarified experimentally from the viewpoint of PS interactions.…”

Section: Introductionmentioning

confidence: 99%

Interaction of phase singularities on the spiral wave tail: reconsideration of capturing the excitable gap

Tomii

Yamazaki

Arafune

et al. 2018

American Journal of Physiology-Heart and Circulatory Physiology

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The action mechanism of stimulation toward spiral waves (SWs) owing to the complex excitation patterns that occur just after point stimulation has not yet been experimentally clarified. This study sought to test our hypothesis that the effect of capturing excitable gap of SWs by stimulation can also be explained as the interaction of original phase singularity (PS) and PSs induced by the stimulation on the wave tail (WT) of the original SW. Phase variance analysis was used to quantitatively analyze the postshock PS trajectories. In a two-dimensional subepicardial layer of Langendorff-perfused rabbit hearts, optical mapping was used to record the excitation pattern during stimulation. After a SW was induced by S1-S2 shock, single biphasic point stimulation S3 was applied. In 70 of the S1-S2-S3 stimulation episodes applied on 6 hearts, the original PS was clearly observed just before the S3 point stimulation in 37 episodes. Pairwise PSs were newly induced by the S3 in 20 episodes. The original PS collided with the newly induced PSs in 16 episodes; otherwise, they did not interact with the original PS. SW shift occurred most efficiently when the S3 shock was applied at the relative refractory period, and PS shifted in the direction of the WT. In conclusion, quantitative tracking of PS clarified that stimulation in desirable conditions induces pairwise PSs on WT and that the collision of PSs causes SW shift along the WT. The results of this study indicate the importance of the interaction of shock-induced excitation with the WT for effective stimulation. NEW & NOTEWORTHY The quantitative analysis of spiral wave dynamics during stimulation clarified the action mechanism of capturing the excitable gap, i.e., the induction of pairwise phase singularities on the wave tail and spiral wave shift along the wave tail as a result of these interactions. The importance of the wave tail for effective stimulation was revealed.

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“…In the phase maps, rotors are represented by phase singularity (PS) points [5] that are surrounded by regions in all possible phases of electrical activation [6,7].…”

Section: Introductionmentioning

confidence: 99%

Phase Analysis of Endoatrial Electrograms for 3D Rotor Detection in Atrial Fibrillation

Valinoti¹,

Berto²,

Alessandrini³

et al. 2017

Computing in Cardiology Conference (CinC)

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A New Efficient Method for Detecting Phase Singularity in Cardiac Fibrillation

Cited by 12 publications

References 46 publications

In situ procedure for high-efficiency computational modeling of atrial fibrillation reflecting personal anatomy, fiber orientation, fibrosis, and electrophysiology

In situ procedure for high-efficiency computational modeling of atrial fibrillation reflecting personal anatomy, fiber orientation, fibrosis, and electrophysiology

Interaction of phase singularities on the spiral wave tail: reconsideration of capturing the excitable gap

Phase Analysis of Endoatrial Electrograms for 3D Rotor Detection in Atrial Fibrillation

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