Validation of the Frequency Spectra Obtained from the Noncontact Unipolar Electrograms During Atrial Fibrillation

Lin, Yenn‐Jiang; Higa, Satoshi; Kao, Tsair; Tso, Han-Wen; Tai, Ching‐Tai; Chang, Shih‐Lin; Lo, Li‐Wei; Wongcharoen, Wanwarang; Chen, Shih‐Ann

doi:10.1111/j.1540-8167.2007.00924.x

Cited by 26 publications

(55 citation statements)

References 20 publications

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“…The technique of analysing DF using non-contact mapping of virtual AF electrograms has previously been studied and validated by other researchers [16,43,44]. Sanders and colleagues terminated human AF in catheter ablation guided by contact DF mapping using windows of 4096 samples with sampling frequency of 1 kHz, using time windows of 4 seconds [9].…”

Section: Fft Window Sizementioning

confidence: 99%

An interactive platform to guide catheter ablation in human persistent atrial fibrillation using dominant frequency, organization and phase mapping

Salinet

Almeida

et al. 2017

Computer Methods and Programs in Biomedicine

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Section: Fft Window Sizementioning

confidence: 99%

An interactive platform to guide catheter ablation in human persistent atrial fibrillation using dominant frequency, organization and phase mapping

Salinet

Almeida

et al. 2017

Computer Methods and Programs in Biomedicine

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“…[22][23][24] The accuracy of reconstructed electrograms is decreased at a distance >40 mm from the center of the array, particularly during AF. 22 In the present study group of AF patients, the average parasternal long-axis LA diameter was only 41±6 mm on transthoracic echocardiography.…”

Section: Study Limitationsmentioning

confidence: 99%

Noncontact Mapping-Guided Catheter Ablation of Atrial Fibrillation

Kumagai

Nakashima

2009

Circ J

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Circ J 2009; 73: 233 -241 revious studies have demonstrated that the pulmonary veins (PVs) are a source of triggers that initiate and perpetuate atrial fibrillation (AF), 1,2 so radiofrequency catheter ablation that electrically isolates the PVs has been used to treat AF. [1][2][3][4] To improve the clinical outcome, additional linear ablation to modify the substrate of AF has been proposed, 5-7 and we recently described an alternative approach of complete isolation of the posterior left atrium (LA), including all the PVs, for treating AF, namely the Box isolation. 8 However, this procedure is technically challenging because of variant atrial conductions, incomplete lesion lines or recovered conduction gaps being proarrhythmic. Editorial p 227Furthermore, during the procedure, non-PV foci can spontaneously occur, and atrial tachycardia or flutter can be induced after the Box lesion lines are completed. It is difficult to localize focal triggers and multiple conduction gaps, and analyze the mechanism of the atrial tachyarrhythmias with conventional point-to-point mapping. A noncontact mapping (NCM) system with a single-beat mapping capacity can facilitate the identification of the triggering sites of AF. 9-12 NCM allows fast recognition of the earliest depolarization sites, propagation patterns and conduction gaps, and also characterizes the relationship to the underlying anatomical structures. Therefore, we conducted this study to evaluate the feasibility and efficacy of the Box isolation using a NCM system. Methods Patient CharacteristicsThe study population consisted of 188 consecutive patients (166 men, 22 women; mean age 59±11 years) with paroxysmal (n=116), persistent (n=48) and longstanding persistent AF (n=24) who were referred for an electrophysiological study and catheter ablation. Persistent AF was defined as AF that was sustained beyond 7 days and requiring pharmacologic or electrical cardioversion. Longstanding persistent AF was defined as continuous AF of more than 1 year (mean, 91±69 months, range 12-240 months). The mean LA diameter was 41±6 mm and the mean ejection fraction was 63±8% as determined by echocardiography. A mean of 3.0±1.0 antiarrhythmic drugs had been administered, but failed to maintain normal sinus rhythm. None of the patients had been treated with amiodarone within the 6 months preceding the procedure. No structural heart disease was present in 65 patients. Valvular disease was documented in 22 patients, cardiomyopathy in 8, coronary artery disease in 8, and sick sinus syndrome in 2. Hypertension was present in 83 patients. Written informed consent was given by all patients. Electrophysiological StudyAll patients received oral anticoagulants for at least 1 month before the ablation. Transesophageal echocardiography was performed to exclude any LA thrombi and antiarrhythmic drugs were discontinued for 5 half-lives before the procedure. Three 5-Fr quadripolar electrode catheters (St Jude Medical (SJM), St Paul, MN, USA) were placed in the high right atrium, His bundle area, and...

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“…8,10 In the present study, further validation of noncontact electrograms during AF in the LA was performed by comparison with the corresponding contact electrograms from 62 randomly distributed LA locations in 4 patients with persistent AF. Unipolar signals were recorded by the 4-mm-tip mapping catheter and were directly compared with the simultaneously acquired noncontact electrograms.…”

Section: Validation Of the Noncontact Electrograms And The Frequency mentioning

confidence: 99%

“…Noncontact mapping (EnSite Array; St. Jude Medical, St. Paul, MN) is a unique tool for simultaneous, high-density global mapping, and we and others have validated its use in the ventricle and atrium. [6][7][8][9][10] To address the critical question of spatiotemporal stability underlying the rationale for targeting high-frequency areas for ablation in AF and to address the hypothesis that such regions are spatiotemporally stable, we have combined the 2 techniques of spectral analysis and noncontact mapping to characterize simultaneous, global LA DF distribution during spontaneous human paroxysmal and persistent AF.…”

Section: Clinical Perspective On P 658mentioning

confidence: 99%

“…Noncontact mapping and electrogram reconstruction in the atria during AF using the EnSite system have previously been validated in animals 8 and humans, 7,9,10 including in the frequency domain. 8,10 In the present study, further validation of noncontact electrograms during AF in the LA was performed by comparison with the corresponding contact electrograms from 62 randomly distributed LA locations in 4 patients with persistent AF.…”

Section: Validation Of the Noncontact Electrograms And The Frequency mentioning

confidence: 99%

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Spatiotemporal Behavior of High Dominant Frequency During Paroxysmal and Persistent Atrial Fibrillation in the Human Left Atrium

Jarman

Wong

Kojodjojo

et al. 2012

Circ: Arrhythmia and Electrophysiology

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Background-Sites of high dominant frequency (DF peak ) are thought to indicate the location of drivers of atrial fibrillation (AF), but characterization of their spatiotemporal distribution and stability, critical to their relevance as targets for catheter ablation, requires simultaneous global mapping of the left atrium. Methods and Results-Noncontact electrograms recorded simultaneously from 256 left atrial sites during spontaneous AF were analyzed. After subtraction of the ventricular component, fast Fourier transform identified the DF at each site. Focal areas of DF peak were defined as those having a DF >20% above all neighboring sites. Twenty-four patients with spontaneous AF (11 paroxysmal and 13 persistent) were studied. In paroxysmal AF, sites of DF peak (mean DF, 11.6±2.9 Hz) were observed in 100% of patients (present during 65% of the mapping period). In contrast, DF peak was detected in only 31% of patients with persistent AF (P<0.001) and for only 5% of the mapping period (P<0.001). In both groups, locations of DF peak varied widely in both consecutive and separated segments of AF (κ coefficient range, -0.07-0.22). Activation sequences around sites of DF peak did not demonstrate centrifugal activation that would be expected from focal drivers. Conclusions-Focal areas of high DF are more frequent in paroxysmal than persistent AF, are spatiotemporally unstable, are not the source of centrifugal activation, and are not, therefore, indicative of fixed drivers of AF. In the absence of spatiotemporal stability, the success of ablation at sites of DF peak cannot be explained by elimination of fixed drivers.(Circ Arrhythm Electrophysiol. 2012;5:650-658.)

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Validation of the Frequency Spectra Obtained from the Noncontact Unipolar Electrograms During Atrial Fibrillation

Abstract: The accuracy of the noncontact unipolar Eg morphology decreased when the mapping sites harbored a smaller atrial voltage and longer distance to the array center. The DF difference between the contact and noncontact unipolar Eg was not affected by the distance to the array center.

Cited by 26 publications

References 20 publications

An interactive platform to guide catheter ablation in human persistent atrial fibrillation using dominant frequency, organization and phase mapping

An interactive platform to guide catheter ablation in human persistent atrial fibrillation using dominant frequency, organization and phase mapping

Noncontact Mapping-Guided Catheter Ablation of Atrial Fibrillation

Spatiotemporal Behavior of High Dominant Frequency During Paroxysmal and Persistent Atrial Fibrillation in the Human Left Atrium

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