Use of Fast Fourier Transform Analysis of Atrial Electrograms for Rapid Characterization of Atrial Activation—Implications for Delineating Possible Mechanisms of Atrial Tachyarrhythmias

Ryu, Kyungmoo; Sahadevan, Jayakumar; Khrestian, M B S Celeen; Stambler, Bruce S.; Waldo, Albert L.

doi:10.1111/j.1540-8167.2005.00320.x

Cited by 32 publications

(42 citation statements)

References 25 publications

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“…23 Thus, the pattern of fibrosis in CHF dogs is highly suggestive of replacement fibrosis after earlier damage to the atrial myocardium, as opposed to the reactive fibrosis pattern in LT goats. Interestingly, the pattern of fibrillatory conduction in CHF model is relatively simple, and consistent with macro-reentry, 24,25 as opposed to the complex fibrillation patterns observed in LT goats. 4 Although a direct comparison is not straightforward because of the different species and other confounding factors, this supports the notion that the exact type and distribution of fibrous tissue is at least as important as the overall degree of fibrosis.…”

Section: Discussionmentioning

confidence: 90%

Loss of Continuity in the Thin Epicardial Layer Because of Endomysial Fibrosis Increases the Complexity of Atrial Fibrillatory Conduction

Verheule

Tuyls

Gharaviri

et al. 2013

Circ: Arrhythmia and Electrophysiology

115

102

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Background— The transition from persistent to permanent atrial fibrillation (AF) is associated with increased complexity of fibrillatory conduction. We have investigated the spatial distribution of fibrillation waves and structural alterations in the atrial free walls in a goat model of AF. Methods and Results— AF was maintained for 3 weeks (short term [ST], persistent AF) or 6 months (long term [LT], permanent AF). Fibrillation patterns were assessed with epicardial mapping. The origin of fibrillation waves and sites of conduction abnormalities were more homogeneously distributed in LT than in ST goats. Histologically, the total area fraction occupied by fibrous tissue and the degree of perimysial fibrosis (separation between myocyte bundles) were not significantly different between groups. However, endomysial fibrosis (distance between myocytes within bundles) was significantly larger in LT goats, particularly in the outer millimeter of the atria. By contrast, myocyte diameters were larger in LT goats throughout the atrial walls. High-resolution optical mapping showed that epicardial wavefront expansion was slower and more anisotropic in LT than in ST goats. Finally, a mathematical model of a simplified atrial architecture confirmed the potential impact of epicardial endomysial fibrosis on AF complexity. Conclusions— Altered propagation after 6 months of AF is consistent with homogeneous structural remodeling in the outer millimeter of the atria. Loss of continuity of the epicardial layer because of endomysial fibrosis may reduce its synchronizing effect, thereby increasing the complexity of fibrillatory conduction pathways. The exact distribution of fibrosis may be more important for the occurrence of conduction disturbances than the overall quantity.

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Section: Discussionmentioning

confidence: 90%

Loss of Continuity in the Thin Epicardial Layer Because of Endomysial Fibrosis Increases the Complexity of Atrial Fibrillatory Conduction

Verheule

Tuyls

Gharaviri

et al. 2013

Circ: Arrhythmia and Electrophysiology

115

102

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“…These differences in substrate (either structural or electrical) and conduction may in turn lead to differences in the characteristic and spatiotemporal organization of the AF in each model. Recently, several different signal analyses have been used to study the spatiotemporal organization of AF to gain insights into its mechanism, including frequency domain analysis (9,21,31,40) and crosscorrelation (6). Through frequency domain analysis, stable high-frequency areas have been shown as a characteristic of AF (40).…”

mentioning

confidence: 99%

Structural atrial remodeling alters the substrate and spatiotemporal organization of atrial fibrillation: a comparison in canine models of structural and electrical atrial remodeling

Everett

Wilson

Verheule

et al. 2006

American Journal of Physiology-Heart and Circulatory Physiology

110

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. Structural atrial remodeling alters the substrate and spatiotemporal organization of atrial fibrillation: a comparison in canine models of structural and electrical atrial remodeling. Am J Physiol Heart Circ Physiol 291: H2911-H2923, 2006. First published July 28, 2006 doi:10.1152/ajpheart.01128.2005.-Several animal models of atrial fibrillation (AF) have been developed that demonstrate either atrial structural remodeling or atrial electrical remodeling, but the characteristics and spatiotemporal organization of the AF between the models have not been compared. Thirty-nine dogs were divided into five groups: rapid atrial pacing (RAP), chronic mitral regurgitation (MR), congestive heart failure (CHF), methylcholine (Meth), and control. Right and left atria (RA and LA, respectively) were simultaneously mapped during episodes of AF in each animal using highdensity (240 electrodes) epicardial arrays. Multiple 30-s AF epochs were recorded in each dog. Fast Fourier transform was calculated every 1 s over a sliding 2-s window, and dominant frequency (DF) was determined. Stable, discrete, high-frequency areas were seen in none of the RAP or control dogs, four of nine MR dogs, four of six CHF dogs, and seven of nine Meth dogs in either the RA or LA or both. Average DFs in the Meth model were significantly greater than in all other models in both LA and RA except LA DFs in the RAP model. The RAP model was the only one with a consistent LA-to-RA DF gradient (9.5 Ϯ 0.2 vs. 8.3 Ϯ 0.3 Hz, P Ͻ 0.00005). The Meth model had a higher spatial and temporal variance of DFs and lower measured organization levels compared with the other AF models, and it was the only model to show a linear relationship between the highest DF and dispersion (R 2 ϭ 0.86). These data indicate that structural remodeling of atria (models known to have predominantly altered conduction) leads to an AF characterized by a stable highfrequency area, whereas electrical remodeling of atria (models known to have predominantly shortened refractoriness without significant conduction abnormalities) leads to an AF characterized by multiple high-frequency areas and multiple wavelets. Fourier analysis; mapping; arrhythmia; electrophysiology ATRIAL FIBRILLATION (AF) is a common arrhythmia that is associated with varied underlying structural heart diseases or can be idiopathic. Because of the variety of clinical settings in which AF occurs, several animal models have been developed to study the pathophysiology of AF in each setting (10,17,20,25,27,36,40,43,44). Although AF occurs in each of the animal models, the atrial substrate of the AF appears to be different among the animal models. For example, the rapid atrial pacing (RAP) and methylcholine (Meth) models have been shown to be dominated by atrial electrical remodeling, which includes a shortening of the atrial refractoriness without atrial structural changes or changes in conduction (25,36,42). In contrast, the mitral regurgitation (MR) and congestive heart failure (CHF) models do not appear to have significant ...

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“…In addition, several signal processing tools have been utilized to study the spatiotemporal organization of AF, and to gain insight into its characteristics and mechanisms. These tools include cross correlation (Botteron and Smith 1995), wavelet analysis (Lee et al 2004), entropy Richman and Moorman 2000), chaos theory (Garfinkel et al 1997;Gray and Jalife 1998), signal linearity (Sih et al 1999), and frequency domain analysis using the FFT Skanes et al 1998;Ryu et al 2006). All of these analyses are being used to help find organization within a seemingly chaotic rhythm, identifying and study mechanisms which could possibly be used to identify ablation sites (Pachon et al 2004;Sanders et al 2005), and to time defibrillation and pacing for AF termination ).…”

Section: Introductionmentioning

confidence: 99%

Changes in the Atrial Substrate Alters the Spatiotemporal Organization and Characteristics of Atrial Fibrillation

Everett¹

2012

Atrial Fibrillation - Basic Research and Clinical Applications

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Use of Fast Fourier Transform Analysis of Atrial Electrograms for Rapid Characterization of Atrial Activation—Implications for Delineating Possible Mechanisms of Atrial Tachyarrhythmias

Abstract: FFT analysis accurately and rapidly identifies global atrial activation patterns during AFL, AT, and AF, thereby assisting in determining arrhythmia mechanisms.

Cited by 32 publications

References 25 publications

Loss of Continuity in the Thin Epicardial Layer Because of Endomysial Fibrosis Increases the Complexity of Atrial Fibrillatory Conduction

Loss of Continuity in the Thin Epicardial Layer Because of Endomysial Fibrosis Increases the Complexity of Atrial Fibrillatory Conduction

Structural atrial remodeling alters the substrate and spatiotemporal organization of atrial fibrillation: a comparison in canine models of structural and electrical atrial remodeling

Changes in the Atrial Substrate Alters the Spatiotemporal Organization and Characteristics of Atrial Fibrillation

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