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rotor ablation atrial fibrillation

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https://www.readbyqxmd.com/read/28339546/multicentre-safety-of-adding-focal-impulse-and-rotor-modulation-firm-to-conventional-ablation-for-atrial-fibrillation
#1
David E Krummen, Tina Baykaner, Amir A Schricker, Christopher A B Kowalewski, Vijay Swarup, John M Miller, Gery F Tomassoni, Shirley Park, Mohan N Viswanathan, Paul J Wang, Sanjiv M Narayan
Aims: Focal Impulse and Rotor Modulation (FIRM) uses 64-electrode basket catheters to identify atrial fibrillation (AF)-sustaining sites for ablation, with promising results in many studies. Accordingly, new basket designs are being tested by several groups. We set out to determine the procedural safety of adding basket mapping and map-guided ablation to conventional pulmonary vein isolation (PVI). Methods and results: We collected 30 day procedural safety data in five US centres for consecutive patients undergoing FIRM plus PVI (FIRM-PVI) compared with contemporaneous controls undergoing PVI without FIRM...
December 22, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28282592/development-of-an-automaton-model-of-rotational-activity-driving-atrial-fibrillation
#2
E J Ciaccio, A B Biviano, E Y Wan, N S Peters, H Garan
BACKGROUND: Atrial fibrillation (AF) is difficult to treat effectively, owing to uncertainty in where to best ablate to eliminate arrhythmogenic substrate. A model providing insight into the electrical activation events would be useful to guide catheter ablation strategy. Method A two-dimensional, 576×576 node automaton was developed to simulate atrial electrical activity. The substrate field was altered by the presence of differing refractory period at varying locations. Fibrosis was added in the form of short, randomly positioned lines of conduction block...
March 2, 2017: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/28279291/clinical-benefit-of-ablating-localized-sources-for-human-atrial-fibrillation-the-indiana-university-firm-registry
#3
John M Miller, Vikas Kalra, Mithilesh K Das, Rahul Jain, Jason B Garlie, Jordan A Brewster, Gopi Dandamudi
BACKGROUND: Mounting evidence shows that localized sources maintain atrial fibrillation (AF). However, it is unclear in unselected "real-world" patients if sources drive persistent atrial fibrillation (PeAF), long-standing persistent atrial fibrillation (LPeAF), or paroxysmal atrial fibrillation (PAF); if right atrial sites are important; and what the long-term success of source ablation is. OBJECTIVES: The aim of this study was to analyze the role of rotors and focal sources in a large academic registry of consecutive patients undergoing source mapping for AF...
March 14, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28269048/an-algorithm-for-rotor-tracking-in-atrial-fibrillation-using-graph-search-based-periodic-peak-detection
#4
Rupin Dalvi, Adrian Suszko, Vijay S Chauhan
Rotors are rotating electrical waves that may sustain atrial fibrillation (AF); thereby providing therapeutic targets for catheter ablation. We propose a method for identifying rotors from circular catheter recordings of bipolar intracardiac electrograms (EGM) during AF. We use dominant frequency-based periodicity detection along with a graph search algorithm to identify the most dominant periodic activations or peaks of interest in each bipolar EGM recorded by a multipolar circular catheter. We then track the activations across catheter bipoles to determine whether they conform to the rotational pattern of a rotor...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28268380/a-novel-catheter-guidance-algorithm-for-localization-of-atrial-fibrillation-rotor-and-focal-sources
#5
Anthony J Salmin, Prasanth Ganesan, Kristina E Shillieto, Elizabeth M Cherry, David T Huang, Arkady M Pertsov, Behnaz Ghoraani
Locating atrial fibrillation (AF) focal and rotor sources can help improve target ablation therapy for AF. However, it remains unclear how to use the information provided by multi-polar diagnostic catheters (MPDC) to locate AF sources. Our aim was to develop a catheter-guidance algorithm to locate AF focal and rotor sources using a conventional MPDC. We simulated a 10 cm × 10 cm atrial tissue with focal and rotor sources using the Nygren et al. ionic model. We modeled a Lasso MPDC with 20-unipole electrodes placed with a spacing of 4...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28268379/kurtosis-as-a-statistical-approach-to-identify-the-pivot-point-of-the-rotor
#6
Shivaram P Arunachalam, Elizabeth M Annoni, Siva K Mulpuru, Paul A Friedman, Elena G Tolkacheva
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia that causes stroke affecting more than 2.3 million people in the US. Catheter ablation to terminate AF is successful for paroxysmal AF but suffers limitations with persistent AF patients as current mapping methods cannot identify AF active substrates outside of pulmonary vein region. In this work, we developed a novel Kurtosis based mapping technique that can accurately identify pivot points of the rotors that were induced in ex-vivo isolated rabbit heart...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28268378/development-of-a-novel-probabilistic-algorithm-for-localization-of-rotors-during-atrial-fibrillation
#7
Prasanth Ganesan, Anthony Salmin, Elizabeth M Cherry, Behnaz Ghoraani
Atrial fibrillation (AF) is an irregular heart rhythm that can lead to stroke and other heart-related complications. Catheter ablation has been commonly used to destroy triggering sources of AF in the atria and consequently terminate the arrhythmia. However, efficient and accurate localization of the AF sustaining sources known as rotors is a major challenge in catheter ablation. In this paper, we developed a novel probabilistic algorithm that can adaptively guide a Lasso diagnostic catheter to locate the center of a rotor...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28256178/adjunctive-ablation-strategies-improve-the-efficacy-of-pulmonary-vein-isolation-in-non-paroxysmal-atrial-fibrillation-a-systematic-review-and-meta-analysis
#8
REVIEW
Muhammad R Afzal, Anweshan Samanta, Jawaria Chatta, Brihh Ansari, Sam Atherton, Syed Sabzwari, Mohit Turagam, Dhanunjaya Lakkireddy, Mahmoud Houmsse
BACKGROUND: Pulmonary vein (PV) isolation (PVI) has suboptimal outcomes in patients with non-paroxysmal atrial fibrillation (AF). Adjunctive strategies employed to ablate non-PV triggers have shown favorable outcomes. AIMS: To delineate the incremental benefit of adjunctive ablation in patients with non-paroxysmal AF through a meta-analysis. METHODS AND RESULTS: Database searches through August 2016 identified five non-randomized and seven randomized controlled trials (enrolling 1694 patients)...
March 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28241971/an-interactive-platform-to-guide-catheter-ablation-in-human-persistent-atrial-fibrillation-using-dominant-frequency-organization-and-phase-mapping
#9
Xin Li, João L Salinet, Tiago P Almeida, Frederique J Vanheusden, Gavin S Chu, G André Ng, Fernando S Schlindwein
BACKGROUND AND OBJECTIVE: Optimal targets for persistent atrial fibrillation (persAF) ablation are still debated. Atrial regions hosting high dominant frequency (HDF) are believed to participate in the initiation and maintenance of persAF and hence are potential targets for ablation, while rotor ablation has shown promising initial results. Currently, no commercially available system offers the capability to automatically identify both these phenomena. This paper describes an integrated 3D software platform combining the mapping of both frequency spectrum and phase from atrial electrograms (AEGs) to help guide persAF ablation in clinical cardiac electrophysiological studies...
April 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28227263/an-algorithm-for-rotor-tracking-in-atrial-fibrillation-using-graph-search-based-periodic-peak-detection
#10
Rupin Dalvi, Adrian Suszko, Vijay S Chauhan, Rupin Dalvi, Adrian Suszko, Vijay S Chauhan, Rupin Dalvi, Adrian Suszko, Vijay S Chauhan
Rotors are rotating electrical waves that may sustain atrial fibrillation (AF); thereby providing therapeutic targets for catheter ablation. We propose a method for identifying rotors from circular catheter recordings of bipolar intracardiac electrograms (EGM) during AF. We use dominant frequency-based periodicity detection along with a graph search algorithm to identify the most dominant periodic activations or peaks of interest in each bipolar EGM recorded by a multipolar circular catheter. We then track the activations across catheter bipoles to determine whether they conform to the rotational pattern of a rotor...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226545/a-novel-catheter-guidance-algorithm-for-localization-of-atrial-fibrillation-rotor-and-focal-sources
#11
Anthony J Salmin, Prasanth Ganesan, Kristina E Shillieto, Elizabeth M Cherry, David T Huang, Arkady M Pertsov, Behnaz Ghoraani, Anthony J Salmin, Prasanth Ganesan, Kristina E Shillieto, Elizabeth M Cherry, David T Huang, Arkady M Pertsov, Behnaz Ghoraani, Arkady M Pertsov, Behnaz Ghoraani, Anthony J Salmin, Kristina E Shillieto, Elizabeth M Cherry, Prasanth Ganesan, David T Huang
Locating atrial fibrillation (AF) focal and rotor sources can help improve target ablation therapy for AF. However, it remains unclear how to use the information provided by multi-polar diagnostic catheters (MPDC) to locate AF sources. Our aim was to develop a catheter-guidance algorithm to locate AF focal and rotor sources using a conventional MPDC. We simulated a 10 cm × 10 cm atrial tissue with focal and rotor sources using the Nygren et al. ionic model. We modeled a Lasso MPDC with 20-unipole electrodes placed with a spacing of 4...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226544/kurtosis-as-a-statistical-approach-to-identify-the-pivot-point-of-the-rotor
#12
Shivaram P Arunachalam, Elizabeth M Annoni, Siva K Mulpuru, Paul A Friedman, Elena G Tolkacheva, Shivaram P Arunachalam, Elizabeth M Annoni, Siva K Mulpuru, Paul A Friedman, Elena G Tolkacheva, Elena G Tolkacheva, Paul A Friedman, Elizabeth M Annoni, Siva K Mulpuru, Shivaram P Arunachalam
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia that causes stroke affecting more than 2.3 million people in the US. Catheter ablation to terminate AF is successful for paroxysmal AF but suffers limitations with persistent AF patients as current mapping methods cannot identify AF active substrates outside of pulmonary vein region. In this work, we developed a novel Kurtosis based mapping technique that can accurately identify pivot points of the rotors that were induced in ex-vivo isolated rabbit heart...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226543/development-of-a-novel-probabilistic-algorithm-for-localization-of-rotors-during-atrial-fibrillation
#13
Prasanth Ganesan, Anthony Salmin, Elizabeth M Cherry, Behnaz Ghoraani, Prasanth Ganesan, Anthony Salmin, Elizabeth M Cherry, Behnaz Ghoraani, Elizabeth M Cherry, Prasanth Ganesan, Behnaz Ghoraani, Anthony Salmin
Atrial fibrillation (AF) is an irregular heart rhythm that can lead to stroke and other heart-related complications. Catheter ablation has been commonly used to destroy triggering sources of AF in the atria and consequently terminate the arrhythmia. However, efficient and accurate localization of the AF sustaining sources known as rotors is a major challenge in catheter ablation. In this paper, we developed a novel probabilistic algorithm that can adaptively guide a Lasso diagnostic catheter to locate the center of a rotor...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28215065/application-of-computer-models-on-atrial-fibrillation-research
#14
Michela Masè
Atrial fibrillation (AF) is a multifactorial and multiscale disease, where electrical, structural, anatomical and genetic factors contribute to the emergence of a complex and dynamic macroscopic phenotype. The incomplete understanding of AF mechanisms and the diversity and multiplicity of factors promoting the arrhythmia in humans have hampered the development of effective therapeutic approaches. Computer models and simulation of atrial arrhythmias may represent an unique allied to investigate AF mechanisms and direct therapeutic strategies, being able to merge and provide interpretation for multiscale data from cellular to entire organ scale levels...
February 17, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28120392/impact-of-rotor-temperospatial-stability-on-acute-and-one-year-atrial-fibrillation-ablation-outcomes
#15
Muhammad Balouch, Esra Gucuk Ipek, Jonathan Chrispin, Rizma J Bajwa, Tarek Zghaib, Ronald D Berger, Hiroshi Ashikaga, Saman Nazarian, Joseph E Marine, Hugh Calkins, David D Spragg
BACKGROUND: The utility of rotor ablation using commercially available systems as an adjunct to pulmonary vein isolation (PVI) is controversial. Variable results may stem from heterogeneous practice patterns. We investigated whether a prespecified protocol to determine temperospatial rotor stability improved acute and intermediate outcomes following rotor ablation. HYPOTHESIS: Protocolized rotor mapping and ablation, with prespecified metrics to determine temporal rotor stability prior to ablation, will improve short- and long-term PVI/rotor ablation outcomes...
January 25, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28113283/identification-of-rotors-during-human-atrial-fibrillation-using-contact-mapping-and-phase-singularity-detection-technical-considerations
#16
Pawel Kuklik, Stef Zeemering, Arne van Hunnik, Bart Maesen, Laurent Pison, Dennis Lau, Jos Maessen, Piotr Podziemski, Christian Meyer, Benjamin Schaffer, Harry Crijns, Stephan Willems, Ulrich Schotten
OBJECTIVE: To explore technical challenges of phase singularity mapping during Atrial Fibrillation (AF) using direct contact electrograms. METHODS: AF mapping was performed in high-density epicardial recordings of human paroxysmal (PAF) or persistent (PersAF) (N=20 pts) AF with an array of 16x16 electrodes placed on atrial epicardium. Phase singularity (PS) points were detected using subsets of electrodes forming rings of varying size. RESULTS: PS detection using a 2x2 electrode ring identified 0...
April 15, 2016: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28039924/focal-impulse-and-rotor-modulation-for-the-treatment-of-atrial-fibrillation-locations-and-one-year-outcomes-of-human-rotors-identified-using-a-64-electrode-basket-catheter
#17
Roland Richard Tilz, Tina Lin, Andreas Rillig, Christian-H Heeger, Leonie Scholz, Peter Wohlmuth, Tudor Bucur, Andreas Metzner, Shibu Mathew, Erik Wissner, Feifan Ouyang, Karl-Heinz Kuck
INTRODUCTION: Pulmonary vein isolation (PVI) is currently the gold standard for catheter ablation of atrial fibrillation (AF). The mechanism for AF-maintenance is still controversial. The concept of rapidly-activating spiral rotors perpetuating AF has led to the development of several rotor-mapping systems. We present our experience with focal impulse and rotor modulation (FIRM) using a 64-electrode basket catheter and computational system and evaluate its feasibility in conjunction with PVI to treat AF...
December 31, 2016: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28011842/modelling-methodology-of-atrial-fibrosis-affects-rotor-dynamics-and-electrograms
#18
Caroline H Roney, Jason D Bayer, Sohail Zahid, Marianna Meo, Patrick M J Boyle, Natalia A Trayanova, Michel Haïssaguerre, Rémi Dubois, Hubert Cochet, Edward J Vigmond
AIMS: Catheter ablation is an effective technique for terminating atrial arrhythmia. However, given a high atrial fibrillation (AF) recurrence rate, optimal ablation strategies have yet to be defined. Computer modelling can be a powerful aid but modelling of fibrosis, a major factor associated with AF, is an open question. Several groups have proposed methodologies based on imaging data, but no comparison to determine which methodology best corroborates clinically observed reentrant behaviour has been performed...
December 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27921187/rotor-tracking-using-phase-of-electrograms-recorded-during-atrial-fibrillation
#19
Caroline H Roney, Chris D Cantwell, Norman A Qureshi, Rasheda A Chowdhury, Emmanuel Dupont, Phang Boon Lim, Edward J Vigmond, Jennifer H Tweedy, Fu Siong Ng, Nicholas S Peters
Extracellular electrograms recorded during atrial fibrillation (AF) are challenging to interpret due to the inherent beat-to-beat variability in amplitude and duration. Phase mapping represents these voltage signals in terms of relative position within the cycle, and has been widely applied to action potential and unipolar electrogram data of myocardial fibrillation. To date, however, it has not been applied to bipolar recordings, which are commonly acquired clinically. The purpose of this study is to present a novel algorithm for calculating phase from both unipolar and bipolar electrograms recorded during AF...
December 5, 2016: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/27826248/slow-conduction-in-the-border-zones-of-patchy-fibrosis-stabilizes-the-drivers-for-atrial-fibrillation-insights-from-multi-scale-human-atrial-modeling
#20
Ross Morgan, Michael A Colman, Henry Chubb, Gunnar Seemann, Oleg V Aslanidi
Introduction: The genesis of atrial fibrillation (AF) and success of AF ablation therapy have been strongly linked with atrial fibrosis. Increasing evidence suggests that patient-specific distributions of fibrosis may determine the locations of electrical drivers (rotors) sustaining AF, but the underlying mechanisms are incompletely understood. This study aims to elucidate a missing mechanistic link between patient-specific fibrosis distributions and AF drivers. Methods: 3D atrial models integrated human atrial geometry, rule-based fiber orientation, region-specific electrophysiology, and AF-induced ionic remodeling...
2016: Frontiers in Physiology
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