scholarly journals Atrial fibrillation driver identification through regional mutual information networks: a modeling perspective

2022 ◽  
Author(s):  
Qun Sha ◽  
Luizetta Elliott ◽  
Xiangming Zhang ◽  
Tzachi Levy ◽  
Tushar Sharma ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
High Resolution ◽  
Mutual Information ◽  
Atrial Remodeling ◽  
Regional Mapping ◽  
Activation Patterns ◽  
Local Efficiency ◽  
Atrial Tissue ◽  
Resolution Mapping ◽  
Mapping Catheter

Abstract Purpose Effective identification of electrical drivers within remodeled tissue is a key for improving ablation treatment for atrial fibrillation. We have developed a mutual information, graph-based approach to identify and propose fault tolerance metric of local efficiency as a distinguishing feature of rotational activation and remodeled atrial tissue. Methods Voltage data were extracted from atrial tissue simulations (2D Karma, 3D physiological, and the Multiscale Cardiac Simulation Framework (MSCSF)) using multi-spline open and parallel regional mapping catheter geometries. Graphs were generated based on varied mutual information thresholds between electrode pairs and the local efficiency for each graph was calculated. Results High-resolution mapping catheter geometries can distinguish between rotational and irregular activation patterns using the derivative of local efficiency as a function of increasing mutual information threshold. The derivative is decreased for rotational activation patterns comparing to irregular activations in both a simplified 2D model (0.0017 ± 1 × 10−4 vs. 0.0032 ± 1 × 10−4, p < 0.01) and a more realistic 3D model (0.00092 ± 5 × 10−5 vs. 0.0014 ± 4 × 10−5, p < 0.01). Average local efficiency derivative can also distinguish between degrees of remodeling. Simulations using the MSCSF model, with 10 vs. 90% remodeling, display distinct derivatives in the grid design parallel spline catheter configuration (0.0015 ± 5 × 10−5 vs. 0.0019 ± 6 × 10−5, p < 0.01) and the flower shaped open spline configuration (0.0011 ± 5 × 10−5 vs. 0.0016 ± 4 × 10−5, p < 0.01). Conclusion A decreased derivative of local efficiency characterizes rotational activation and varies with atrial remodeling. This suggests a distinct communication pattern in cardiac rotational activation detectable via high-resolution regional mapping and could enable identification of electrical drivers for targeted ablation.

scholarly journals TASK-1 current is inhibited by phosphorylation during human and canine chronic atrial fibrillation

2015 ◽  
Vol 308 (2) ◽  
pp. H126-H134 ◽  
Author(s):  
Erin Harleton ◽  
Alessandra Besana ◽  
Parag Chandra ◽  
Peter Danilo ◽  
Tove S. Rosen ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Normal Sinus Rhythm ◽  
Human Subjects ◽  
Phosphorylation Site ◽  
Chronic Atrial Fibrillation ◽  
Resting Membrane Potential ◽  
Atrial Remodeling ◽  
Protein Levels ◽  
Atrial Tissue ◽  
Normal Sinus

Atrial fibrillation (AF) is a common arrhythmia with significant morbidities and only partially adequate therapeutic options. AF is associated with atrial remodeling processes, including changes in the expression and function of ion channels and signaling pathways. TWIK protein-related acid-sensitive K+ channel (TASK)-1, a two-pore domain K+ channel, has been shown to contribute to action potential repolarization as well as to the maintenance of resting membrane potential in isolated myocytes, and TASK-1 inhibition has been associated with the induction of perioperative AF. However, the role of TASK-1 in chronic AF is unknown. The present study investigated the function, expression, and phosphorylation of TASK-1 in chronic AF in atrial tissue from chronically paced canines and in human subjects. TASK-1 current was present in atrial myocytes isolated from human and canine hearts in normal sinus rhythm but was absent in myocytes from humans with AF and in canines after the induction of AF by chronic tachypacing. The addition of phosphatase to the patch pipette rescued TASK-1 current from myocytes isolated from AF hearts, indicating that the change in current is phosphorylation dependent. Western blot analysis showed that total TASK-1 protein levels either did not change or increased slightly in AF, despite the absence of current. In studies of perioperative AF, we have shown that phosphorylation of TASK-1 at Thr383 inhibits the channel. However, phosphorylation at this site was unchanged in atrial tissue from humans with AF or in canines with chronic pacing-induced AF. We conclude that phosphorylation-dependent inhibition of TASK-1 is associated with AF, but the phosphorylation site responsible for this inhibition remains to be identified.

scholarly journals Regional entrainment of atrial fibrillation studied by high-resolution mapping in open-chest dogs.

Circulation ◽  
1993 ◽  
Vol 88 (2) ◽  
pp. 736-749 ◽  
Author(s):  
C Kirchhof ◽  
F Chorro ◽  
G J Scheffer ◽  
J Brugada ◽  
K Konings ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
High Resolution ◽  
High Resolution Mapping ◽  
Open Chest ◽  
Resolution Mapping

Abstract 12750: Atrial Tissue MicroRNAs 411-5p, 21-5p, 409-3p and 320a Are Associated With Atrial Fibrillation

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Menhel Kinno ◽  
Nada Esa ◽  
Raghava S Velagaleti ◽  
Amir Y Shaikh ◽  
Honghuang Lin ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Atrial Remodeling ◽  
Tissue Samples ◽  
Elective Cardiac Surgery ◽  
Atrial Tissue ◽  
Prior Literature ◽  
History Of ◽  
Artery Disease ◽  
The Right ◽  
Age And Sex

Introduction: Atrial Fibrillation (AF) is the most common arrhythmia in clinical practice. MicroRNAs (miRs) are small RNAs that play a role in regulating cardiac remodeling and have been implicated in cardiac arrhythmogenesis. However, few studies have examined the association of atrial miR expression to AF. Hypothesis: Changes in miR expression (estimated as fold-difference in the delta cycle threshold compared to global mean) in human atria can be associated with AF. Methods: Thirty-one consecutive patients undergoing elective cardiac surgery were divided into 2 groups: those with history of AF (n=19) and those with no history of AF who stayed in sinus rhythm post-operatively (n=12). Atrial tissue samples were obtained from the right atrium in all but one (left atrium). Based on pilot data and prior literature, the expression of 82 miRs was assessed using high-throughput quantitative reverse-transcriptase polymerase chain reaction. We used logistic regression adjusting for age and sex to detect the associations between levels of atrial miRs and AF. Results: The mean age of the sample was 65 years (±13) and 71% were men. A history of coronary artery disease and heart failure was present in 42% and 36%, respectively. Among AF subjects, the age- and sex- adjusted odds ratios for the expression of miRs 411-5p, 21-5p, 409-3p and 320a were 0.08 (p= 0.02), 0.20 (p=0.02), 0.13 (p= 0.04) and 0.04 (p=0.048), respectively, compared to no AF. The fold-difference in atrial expression of miRs 411-5p, 21-5p, 409-3p and 320a were -0.567, -0.588, -0.375 and -0.427, respectively, in those with AF compared to no AF. Conclusion: In our study, the atrial expression of miRs 411, 21, 409 and 320 was lower in AF patients compared to those with no AF. Notably, these miRs regulate genes involved in atrial fibrosis, apoptosis, and ion channel function. Our findings further implicate miRs as important mediators of pathological atrial remodeling and suggest their usefulness as biomarkers in detecting AF.

Abstract 16342: Feasibility and Safety of Intra-operative Mapping for Diagnosis of the Substrate of Atrial Fibrillation

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Lisette van der Does ◽  
Ameetha Yaksh ◽  
Charles Kik ◽  
Paul Knops ◽  
Frans Oei ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Mean Arterial Pressure ◽  
High Resolution ◽  
Arterial Pressure ◽  
Right Atrial ◽  
Epicardial Mapping ◽  
High Resolution Mapping ◽  
Mapping Approach ◽  
Resolution Mapping ◽  
Atrial Mapping

Introduction: Multi-site, high-resolution mapping can be used to identify either the trigger or substrate perpetuating atrial fibrillation (AF). The goal of this study was to assess the feasibility and safety of a new high-resolution epicardial mapping approach. Hypothesis: Epicardial atrial mapping of the entire atria can be safely performed as a routine procedure during cardiac surgery. Methods: Epicardial mapping of the entire right atrium, left atrium and Bachmann’s Bundle was performed in 291 patients (218 male, age:66±11yrs) undergoing elective surgery during sinus rhythm (SR) and (induced) AF using high-resolution mapping arrays with inter-electrode distances of 1-2mm. Electrophysiological parameters were quantified and designated to anatomical quadrants of 1cm2. Results: AF was non-inducible in 36 patients. Hemodynamic parameters (mean arterial pressure, right atrial pressure, BIS score, ST-T segment alterations) before and during SR mapping were comparable (P<0.22). During AF, only mean arterial pressure (71±11 versus 67±10mmHg (P<0.004)) and right atrial pressure (10±4 versus 11±4mmHg (P<0.0001)) decreased. Total mapping time during SR or AF was respectively 3±1min. and 4±2min. Beat-to-beat variation of SR cycle length and peak-to-peak amplitude of unipolar potentials were respectively 0.04±14.42ms and -0.01±0.53mV, reflecting stability of the mapping array. Complications were not observed. Conclusions: Our novel intra-operative epicardial atrial mapping approach can be safely applied during both SR and AF. This mapping approach is the first technique allowing quantification of the arrhythmogenic substrate in the individual patient thereby taking the first step towards personalizing treatment of AF.

scholarly journals Novel noncontact charge density map in the setting of post-atrial fibrillation atrial tachycardias: first experience with the Acutus SuperMap Algorithm

2020 ◽  
Author(s):  
Robbert Ramak ◽  
Gian-Battista Chierchia ◽  
Gaetano Paparella ◽  
Cinzia Monaco ◽  
Vincenzo Miraglia ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
High Resolution ◽  
Charge Density ◽  
Pulmonary Vein ◽  
The Novel ◽  
Mapping Algorithm ◽  
Af Ablation ◽  
High Resolution Mapping ◽  
Resolution Mapping ◽  
The Mean

Abstract Purpose The purpose of this study was to evaluate the safety and feasibility of the new high-resolution mapping algorithm SuperMap (Acutus Medical, CA, USA) in identifying and guiding ablation in the setting of regular atrial tachycardias following index atrial fibrillation (AF) ablation. Methods Seven consecutive patients who underwent a radiofrequency catheter ablation guided by the novel noncontact charge density (CD) SuperMap for atrial tachycardia were prospectively enrolled in our study. Results Arrhythmogenic substrate was identified in all seven patients. Mean number of EGM per map was 5859.7 ± 4348.5 points. Three patients (43%) exhibited focal tachycardia mechanisms in the left atrium, alternating from anteroseptal right superior pulmonary vein (RSPV), posterior in proximity of left inferior pulmonary vein (LIPV), and interarial septum in proximity of fossa ovalis, respectively. Four patients exhibited macroreentrant mechanism. In 3 of these patients, SuperMap detected mitral isthmus-dependent flutters with tachycardia cycle lengths of 240, 270 and 420 ms, respectively. In one patient, the mechanism was a macroreentrant tachycardia with the critical isthmus located between the crista terminalis and atriotomy. The mean ablation time (min) was 18.2 ± 12.5 and the mean procedural duration time was 56.4 ± 12.1 min. No minor or major complications occurred. Conclusion The novel high-resolution mapping algorithm SuperMap proved to be safe, fast, and feasible in identifying and guiding ablation in the setting of regular atrial tachycardias following index AF ablation.

Pulmonary vein-gap re-entrant atrial tachycardia following atrial fibrillation ablation: an electrophysiological insight with high-resolution mapping

EP Europace ◽  
2019 ◽  
Vol 21 (7) ◽  
pp. 1039-1047 ◽  
Author(s):  
Seigo Yamashita ◽  
Masateru Takigawa ◽  
Arnaud Denis ◽  
Nicolas Derval ◽  
Yuichiro Sakamoto ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
High Resolution ◽  
Pulmonary Vein ◽  
Atrial Tachycardia ◽  
Atrial Fibrillation Ablation ◽  
P Wave ◽  
Conduction Time ◽  
High Resolution Mapping ◽  
Mapping System ◽  
Resolution Mapping

Aims The circuit of pulmonary vein-gap re-entrant atrial tachycardia (PV-gap RAT) after atrial fibrillation ablation is sometimes difficult to identify by conventional mapping. We analysed the detailed circuit and electrophysiological features of PV-gap RATs using a novel high-resolution mapping system. Methods and results This multicentre study investigated 27 (7%) PV-gap RATs in 26 patients among 378 atrial tachycardias (ATs) mapped with Rhythmia™ system in 281 patients. The tachycardia cycle length (TCL) was 258 ± 52 ms with P-wave duration of 116 ± 28 ms. Three types of PV-gap RAT circuits were identified: (A) two gaps in one pulmonary vein (PV) (unilateral circuit) (n = 17); (B) two gaps in the ipsilateral superior and inferior PVs (unilateral circuit) (n = 6); and (C) two gaps in one PV with a large circuit around contralateral PVs (bilateral circuit) (n = 4). Rhythmia™ mapping demonstrated two distinctive entrance and exit gaps of 7.6 ± 2.5 and 7.9 ± 4.1 mm in width, respectively, the local signals of which showed slow conduction (0.14 ± 0.18 and 0.11 ± 0.10m/s) with fragmentation (duration 86 ± 27 and 78 ± 23 ms) and low-voltage (0.17 ± 0.13 and 0.17 ± 0.21 mV). Twenty-two ATs were terminated (mechanical bump in one) and five were changed by the first radiofrequency application at the entrance or exit gap. Moreover, the conduction time inside the PVs (entrance-to-exit) was 138 ± 60 ms (54 ± 22% of TCL); in all cases, this resulted in demonstrating P-wave with an isoelectric line in all leads. Conclusion This is the first report to demonstrate the detailed mechanisms of PV-gap re-entry that showed evident entrance and exit gaps using a high-resolution mapping system. The circuits were variable and Rhythmia™-guided ablation targeting the PV-gap can be curative.

Value of high-resolution mapping in optimizing cryoballoon ablation of atrial fibrillation

2018 ◽  
Vol 270 ◽  
pp. 136-142 ◽  
Author(s):  
Giulio Conte ◽  
Kyoko Soejima ◽  
Carlo de Asmundis ◽  
Gian-Battista Chierchia ◽  
Matteo Badini ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
High Resolution ◽  
Cryoballoon Ablation ◽  
High Resolution Mapping ◽  
Resolution Mapping

High Coverage and High-Resolution Mapping of Repetitive Patterns During Atrial Fibrillation

2021 ◽  
Author(s):  
Ozan Ozgul ◽  
Ben Hermans ◽  
Arne Van Hunnik ◽  
Sander Verheule ◽  
Ulrich Schotten ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
High Resolution ◽  
High Coverage ◽  
High Resolution Mapping ◽  
Resolution Mapping
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