Abstract 15668: Noninvasive Mapping Can Predict Success of Ablation for Atrial Fibrillation

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Namita Ravi ◽  
Kian Waddell ◽  
Wouter-Jan Rappel ◽  
Miguel Rodrigo ◽  
Sanjiv M Narayan
Keyword(s):  
Atrial Fibrillation ◽  
Body Surface ◽  
Signal Amplitude ◽  
Dominant Frequency ◽  
The Body ◽  
Body Surface Mapping ◽  
Surface Mapping ◽  
Surface Ecg ◽  
Acute Success ◽  
Noninvasive Mapping

Introduction: It is currently not possible to non-invasively identify patients with atrial fibrillation (AF) who may respond acutely to ablation. We hypothesized that high resolution body surface mapping can identify specific distributions of AF in individuals that predict acute success from ablation. Objective: To correlate 64 lead body surface ECG in AF to acute ablation response and non-invasively identify patients in whom ablation does and does not terminate AF. Method: Fig A shows 64 body surface electrodes in N=17 consecutive AF patients (14 persistent AF, 67 ± 9.06 years). Spectral dominant frequency (DF) from 4096-point FFT, cycle length, AF electrogram amplitude were measured in 200-300 time slices of duration 60s between patches on the body surface representing each atrium (Fig A). Results: Ablation terminated AF in N=7/17 patients (41.2%, Fig. B). Patients with AF termination had more organized AF than those without termination, indicated by lower DF on body surface mapping of the regions corresponding to left (5.00 ± 1.33 vs 5.47 ± 1.30, p < 0.001) and right atrium (5.16 ± 1.50 vs 5.50 ± 1.01, p < 0.003) (Fig C shows composite). DF was stable without statistically significant variations across 20s slices spanning the full minute, supporting interpretability of mechanisms from this analysis (p = NS). Further, AF signal amplitude averaged across left and right atria was lower in patients with AF termination (65.47 ± 36.9 vs 120.13 ± 99.9, p < 0.001) (Fig D). Conclusion: Body surface analysis of AF can non-invasively identify patients in whom ablation may acutely terminate AF. Future studies should determine if this approach can predict who may ultimately achieve long term freedom from AF, and whether body surface signatures are representative enough to be analyzed days prior to the procedure.

scholarly journals P291Rotor distribution and stability in atrial fibrillation using a non invasive body-surface mapping system

EP Europace ◽  
2017 ◽  
Vol 19 (suppl_3) ◽  
pp. iii43-iii43
Author(s):  
C. Lemes ◽  
C. Sohns ◽  
T. Maurer ◽  
M. Chmelevsky ◽  
M. Budanova ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Body Surface ◽  
Body Surface Mapping ◽  
Surface Mapping ◽  
Non Invasive ◽  
Mapping System

scholarly journals 136-25: Rotor Distribution and stability in Atrial Fibrillation Using a Non invasive Body-Surface Mapping System

EP Europace ◽  
2016 ◽  
Vol 18 (suppl_1) ◽  
pp. i96-i96
Author(s):  
Christine Lemes ◽  
Tilmann Maurer ◽  
Michail Chmelevsky ◽  
Christian Sohns ◽  
Alexey Tsyganov ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Body Surface ◽  
Body Surface Mapping ◽  
Surface Mapping ◽  
Non Invasive ◽  
Mapping System

scholarly journals Non-Invasive Assessment of Complexity of Atrial Fibrillation: Correlation with Contact Mapping and Impact of Ablation

2020 ◽  
Author(s):  
Miguel Rodrigo ◽  
Andreu M. Climent ◽  
Ismael Hernández-Romero ◽  
Alejandro Liberos ◽  
Tina Baykaner ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Body Surface ◽  
Response To Therapy ◽  
The Body ◽  
Surface Mapping ◽  
Electrocardiographic Imaging ◽  
Phase Singularity ◽  
Contact Mapping ◽  
Clinical Endpoints ◽  
Non Invasive

Background - It is difficult to non-invasively phenotype atrial fibrillation (AF) in a way that reflects clinical endpoints such as response to therapy. We set out to map electrical patterns of disorganization and regions of reentrant activity in AF from the body surface using electrocardiographic imaging (ECGI), calibrated to panoramic intracardiac recordings and referenced to AF termination by ablation. Methods - Bi-atrial intracardiac electrograms of 47 AF patients at ablation (30 persistent, 29 male, 63±9 years) were recorded with 64-pole basket catheters and simultaneous 57-lead body surface ECGs. Atrial epicardial electrical activity was reconstructed and organized sites were invasively and non-invasively tracked in 3D using phase singularity (PS). In a subset of 17 patients, sites of AF organization were targeted for ablation. Results - Body surface mapping showed greater AF organization near intracardially-detected drivers than elsewhere, both in PS density (2.3±2.1 vs 1.9±1.6, p=0.02) and number of drivers (3.2±2.3 vs 2.7±1.7, p=0.02). Complexity, defined as the number of stable AF reentrant sites, was concordant between non-invasive and invasive methods (r 2 =0.5, CC=0.71). In the subset receiving targeted ablation, AF complexity showed lower values in those in whom AF terminated than those in whom AF did not terminate (p<0.01). Conclusions - AF complexity tracked non-invasively correlates well with organized and disorganized regions detected by panoramic intracardiac mapping, and correlates with the acute outcome by ablation. This approach may assist in bedside monitoring of therapy or in improving the efficacy of ongoing ablation procedures.

scholarly journals Body Surface Mapping to Guide Atrial Fibrillation Ablation

2015 ◽  
Vol 4 (3) ◽  
pp. 172 ◽  
Author(s):  
Seigo Yamashita ◽  
Ashok J Shah ◽  
Saagar Mahida ◽  
Jean-Marc Sellal ◽  
Benjamin Berte ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Body Surface ◽  
Mapping Technique ◽  
Interventional Treatment ◽  
Success Rates ◽  
Body Surface Mapping ◽  
Surface Mapping ◽  
Non Invasive ◽  
Guide Catheter

Atrial fibrillation (AF) is the most common rhythm disorder, and is strongly associated with thromboembolic events and heart failure. Over the past decade, catheter ablation of AF has advanced considerably with progressive improvement in success rates. However, interventional treatment is still challenging, especially for persistent and long-standing persistent AF. Recently, AF analysis using a non-invasive body surface mapping technique has been shown to identify localised reentrant and focal sources, which play an important role in driving and perpetuating AF. Non-invasive mapping-guided ablation has also been reported to be effective for persistent AF. In this review, we describe new clinical insights obtained from non-invasive mapping of persistent AF to guide catheter ablation.

scholarly journals P5513Rotor distribution and stability in atrial fibrillation using a non invasive body-surface mapping system

2017 ◽  
Vol 38 (suppl_1) ◽  
Author(s):  
C. Lemes ◽  
C. Sohns ◽  
T. Maurer ◽  
M. Chmelevsky ◽  
M. Budanova ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Body Surface ◽  
Body Surface Mapping ◽  
Surface Mapping ◽  
Non Invasive ◽  
Mapping System

Abstract 16564: Location of Persistent Atrial Fibrillation Drivers Based on Body Surface Mapping: A Systematic Review and Metanalysis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Abdullah Sarkar ◽  
Mauricio Tellez ◽  
Shane Saifman ◽  
Daniel Weitz
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Body Surface ◽  
Pulmonary Veins ◽  
Final Analysis ◽  
Persistent Atrial Fibrillation ◽  
Body Surface Mapping ◽  
Surface Mapping ◽  
Non Invasive ◽  
Literature Searches

Introduction: Body Surface Mapping (BSM) is a non-invasive electrocardiogram-based mapping system that is used to identify localized drivers in patients with persistent Atrial Fibrillation (AF). Mapping of local drivers is becoming increasingly important in guiding treatment of atrial fibrillation but may not be readily available. We conducted a systematic review to determine the most prevalent atrial regions of AF driver activity identified with BSM. Methods: Electronic literature searches were performed across PubMed, Google Scholar, Cochrane, CINAHL, Web of science, EMBASE databases up to January 2019, for studies that utilized BSM to identify and report localized focal and rotor (reentrant) driver activity. Prevalence of drivers, as a percentage, were recorded for every region according to the Bordeaux Biatrial Schema. Random-effects model was used to calculate weighted averages with the corresponding 95% confidence interval (CI). Results: Total of 468 unique studies were identified and reviewed. 4 prospective cohort studies were included in the final analysis—of which 3 were single-center and 1 was multi-centered; totaling 336 patients. The mean age was 62.8 (±5.41) and 73% were males. The three most prevalent regions with persistent AF foci activity were region 1 (left pulmonary veins and left appendage): 59% (CI 48-71), followed by region 4 (upper half of right atrium and appendage): 31% (CI 12-54), and region 2 (right pulmonary veins and posterior interatrial groove): 19% (CI 7-34). The three most prevalent regions of persistent AF rotor activity were region 3 (inferior and posterior left atrium): 71% (CI 32-98), region 1: 70% (CI 21-100), and region 2: 70% (CI 25-99). Conclusion: In patients with persistent AF, majority of localized drivers seem to originate from specific atrial regions based on BSM.

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