scholarly journals Letter by Berenfeld and Jalife Regarding Article “Dominant Frequency of Atrial Fibrillation Correlates Poorly With Atrial Fibrillation Cycle Length”

2010 ◽  
Vol 3 (1) ◽  
Author(s):  
Omer Berenfeld ◽  
José Jalife
Keyword(s):  
Atrial Fibrillation ◽  
Cycle Length ◽  
Dominant Frequency

Abstract 4104: Organization of Atrial Signals is Critical Prior to Cardioversion of Atrial Fibrillation with Intravenous Flecainide: Insight from Spectral Analysis of Intracardiac Electrograms

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Jiun Tuan ◽  
Suman Kundu ◽  
Mohamed Jeilan ◽  
Faizel Osman ◽  
Rajkumar Mantravadi ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Spectral Analysis ◽  
Catheter Ablation ◽  
Cycle Length ◽  
Dominant Frequency ◽  
Relative Increase ◽  
Significant Difference ◽  
Before And After ◽  
Atrial Activation ◽  
Relative Change

Introduction & Hypothesis: Studies in catheter ablation of atrial fibrillation (AF) show that an increase in cycle length (CL) and higher organization index (OI) is associated with termination of AF. We hypothesize that similar changes can be seen in chemical cardioversion with Flecainide Methods: Patients who were still in AF at the end of catheter ablation for AF were given intravenous flecainide. OI and dominant frequency (DF) were obtained by Fast Fourier Transform of coronary sinus electrograms over 10s in AF, before and after flecainide infusion. Mean CL was also calculated. Results: 28 patients were identified (18 paroxysmal AF and 10 persistent AF). 8 cardioverted to sinus rhythm (SR) with flecainide. In all patients, mean CL increased from 211 ± 44 ms to 321 ± 85 ms (p <0.001). Mean DF decreased from 5.2 ± 1.03 Hz to 3.6 ± 1.04 Hz (p <0.001). Mean OI was 0.33 ± 0.13 before and 0.32 ± 0.11 after flecainide (p = 0.90). Comparing patients who cardioverted to SR with those who did not, OI post-flecainide was 0.41 ± 0.12 vs 0.29 ± 0.10 (p=0.013) and relative change in OI was 29 ± 33% vs −3.9 ± 27% (p=0.016) respectively. No significant difference was noted in the change in CL and DF in the 2 groups. Logistic regression showed that a greater relative increase in OI (p=0.04), a higher OI post-flecainide (p=0.03) and SR at start of procedure (p=0.03) are independently associated with cardioversion to SR with flecainide. Conclusion: Increase in OI, independent of changes to the CL and DF, appears critical to AF termination with flecainide. The increase in OI may reflect an increase in size and reduction in the number of re-entrant circuits, which together with slowing of atrial activation, result in return to SR.

The Relationship Between Electrogram Cycle Length and Dominant Frequency in Patients with Persistent Atrial Fibrillation

2009 ◽  
Vol 20 (12) ◽  
pp. 1336-1342 ◽  
Author(s):  
SHELDON M. SINGH ◽  
E. KEVIN HEIST ◽  
JACOB S. KORUTH ◽  
CONOR D. BARRETT ◽  
JEREMY N. RUSKIN ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cycle Length ◽  
Persistent Atrial Fibrillation ◽  
Dominant Frequency ◽  
The Relationship

scholarly journals Panoramic Endocardial Optical Mapping Demonstrates Serial Rotors Acceleration and Increasing Complexity of Activity During Onset of Cholinergic Atrial Fibrillation

2021 ◽  
Author(s):  
Óscar Salvador‐Montañés ◽  
Rafael J. Ramirez ◽  
Yoshio Takemoto ◽  
Steven R. Ennis ◽  
Daniel Garcia‐Iglesias ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cycle Length ◽  
Optical Mapping ◽  
Dominant Frequency ◽  
Right Atrial ◽  
Mapping System ◽  
Left And Right ◽  
Initiation Stage ◽  
Mean Cycle ◽  
Onset Atrial Fibrillation

Background Activation during onset of atrial fibrillation is poorly understood. We aimed at developing a panoramic optical mapping system for the atria and test the hypothesis that sequential rotors underlie acceleration of atrial fibrillation during onset. Methods and Results Five sheep hearts were Langendorff perfused in the presence of 0.25 µmol/L carbachol. Novel optical system recorded activations simultaneously from the entire left and right atrial endocardial surfaces. Twenty sustained (>40 s) atrial fibrillation episodes were induced by a train and premature stimuli protocol. Movies obtained immediately (Initiation stage) and 30 s (Early Stabilization stage) after premature stimulus were analyzed. Serial rotor formation was observed in all sustained inductions and none in nonsustained inductions. In sustained episodes maximal dominant frequency increased from (mean±SD) 11.5±1.74 Hz during Initiation to 14.79±1.30 Hz at Early Stabilization ( P <0.0001) and stabilized thereafter. At rotor sites, mean cycle length (CL) during 10 prerotor activations increased every cycle by 0.53% ( P =0.0303) during Initiation and 0.34% ( P =0.0003) during Early Stabilization. In contrast, CLs at rotor sites showed abrupt decreases after the rotors appearances by a mean of 9.65% ( P <0.0001) during both stages. At Initiation, atria‐wide accelerations and decelerations during rotors showed a net acceleration result whereby post‐rotors atria‐wide minimal CL (CLmin) were 95.5±6.8% of the prerotor CLmin ( P =0.0042). In contrast, during Early Stabilization, there was no net acceleration in CLmin during accelerating rotors (prerotor=84.9±11.0% versus postrotor=85.8±10.8% of Initiation, P =0.4029). Levels of rotor drift distance and velocity correlated with atria‐wide acceleration. Nonrotor phase singularity points did not accelerate atria‐wide activation but multiplied during Initiation until Early Stabilization. Increasing number of singularity points, indicating increased complexity, correlated with atria‐wide CLmin reduction ( P <0.0001). Conclusions Novel panoramic optical mapping of the atria demonstrates shortening CL at rotor sites during cholinergic atrial fibrillation onset. Atrial fibrillation acceleration toward Early Stabilization correlates with the net result of atria‐wide accelerations during drifting rotors activity.

scholarly journals Regions of Highly Recurrent Electrogram Morphology at Sites of Low Cycle Length Accurately Reflect Arrhythmogenic Substrate for Atrial Fibrillation – Implications For a New, Mechanism Guided Therapeutic Approach for Atrial Fibrillation

2020 ◽  
Author(s):  
Shin Yoo ◽  
Markus Rottmann ◽  
Jason Ng ◽  
David Johnson ◽  
Bassel Shanab ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cycle Length ◽  
Dominant Frequency ◽  
Nerve Fibers ◽  
Atrial Pacing ◽  
Parasympathetic Innervation ◽  
Complexity Measures ◽  
Parasympathetic Nerve ◽  
Arrhythmogenic Substrate ◽  
Before And After

ABSTRACTBackgroundAlthough atrial electrograms (EGMs) are thought to reflect pathophysiological substrate for atrial fibrillation (AF), it is not known which electrograms are suitable targets during AF ablation. We hypothesized that electrogram morphology recurrence (EMR) better reflects arrhythmogenic AF substrate than traditional frequency and complexity measures of AF. In a canine rapid atrial pacing (RAP) model of AF, we assessed the relationship between EMR and traditional AF electrogram measures, rotational activity in the atria, fibrosis, myofiber orientation and parasympathetic innervation.MethodsPersistent AF was induced in 13 dogs by RAP for 6-8 weeks. High-density epicardial mapping (117 electrodes) was performed in six atrial sub-regions. EMR measures Recurrence percentage (Rec%) and cycle length of the most frequent electrogram morphology (CLR), Fractionated Interval (FI), Organization Index (OI), Dominant Frequency (DF) and Shannon’s Entropy (ShEn) were analyzed before and after atropine administration. Myocyte fiber orientation, amount of fibrosis and spatial distribution of parasympathetic nerve fibers were quantified.ResultsRec% was greatest in the appendages, and CLR was lowest in the posterior left atrium. Rec%/CLR correlated with FI, OI and the complexity measure ShEn, but not with DF. All electrogram measures were poorly correlated with fibrosis and myofiber anisotropy. Rec% correlated closely with stability of rotational activity. Unlike other measures, Rec% correlated closely with spatial heterogeneity of parasympathetic nerve fibers; this was reflected in CLR response to atropine.ConclusionEMR correlates closely with stability of rotational activity and with the pattern of atrial parasympathetic innervation. CLR may therefore be a viable therapeutic target in persistent AF.

Prolongation of atrial fibrillation cycle length during catheter ablation at sites of maximal dominant frequency

Heart Rhythm ◽  
2005 ◽  
Vol 2 (5) ◽  
pp. S316-S317
Author(s):  
Prashanthan Sanders ◽  
Omer Berenfeld ◽  
Yoshihide Takahashi ◽  
Ravi Vaidyanathan ◽  
Mélèze Hocini ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Cycle Length ◽  
Dominant Frequency

scholarly journals Dominant Frequency of Atrial Fibrillation Correlates Poorly With Atrial Fibrillation Cycle Length

2009 ◽  
Vol 2 (6) ◽  
pp. 634-644 ◽  
Author(s):  
Arif Elvan ◽  
Andre C. Linnenbank ◽  
Marnix W. van Bemmel ◽  
Anand R. Ramdat Misier ◽  
Peter Paul H.M. Delnoy ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cycle Length ◽  
Dominant Frequency

scholarly journals Cycle Length Evaluation in Persistent Atrial Fibrillation Using Kernel Density Estimation to Identify Transient and Stable Rapid Atrial Activity

2021 ◽  
Author(s):  
Szabolcs Z. Nagy ◽  
Patrick Kasi ◽  
Valtino X. Afonso ◽  
Nathaniel Bird ◽  
Brian Pederson ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Density Estimation ◽  
Kernel Density Estimation ◽  
Cycle Length ◽  
Kernel Density ◽  
Persistent Atrial Fibrillation ◽  
Dominant Frequency ◽  
Segment Length ◽  
Patient Specific ◽  
Atrial Activity

Abstract Purpose Left atrial (LA) rapid AF activity has been shown to co-localise with areas of successful atrial fibrillation termination by catheter ablation. We describe a technique that identifies rapid and regular activity. Methods Eight-second AF electrograms were recorded from LA regions during ablation for psAF. Local activation was annotated manually on bipolar signals and where these were of poor quality, we inspected unipolar signals. Dominant cycle length (DCL) was calculated from annotation pairs representing a single activation interval, using a probability density function (PDF) with kernel density estimation. Cumulative annotation duration compared to total segment length defined electrogram quality. DCL results were compared to dominant frequency (DF) and averaging. Results In total 507 8 s AF segments were analysed from 7 patients. Spearman’s correlation coefficient was 0.758 between independent annotators (P < 0.001), 0.837–0.94 between 8 s and ≥ 4 s segments (P < 0.001), 0.541 between DCL and DF (P < 0.001), and 0.79 between DCL and averaging (P < 0.001). Poorer segment organization gave greater errors between DCL and DF. Conclusion DCL identifies rapid atrial activity that may represent psAF drivers. This study uses DCL as a tool to evaluate the dynamic, patient specific properties of psAF by identifying rapid and regular activity. If automated, this technique could rapidly identify areas for ablation in psAF.

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