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dominant frequency atrial fibrillation ablation

Amit Rozner, Sharon Zlochiver
Atrial ablation has been recently utilized to treat atrial fibrillation (AF) by isolation or destruction of arrhythmia drivers. In chronic or persistent AF patients these drivers often consist of one or few rotors at unknown locations, and several ablations are commonly conducted before arrhythmia is terminated. However, the irreversible damage done to the tissue may lead to AF recurrence. We propose an alternative strategy to terminate rotor activity by its attraction into a non 1:1 conducting region. The feasibility of the method was numerically tested in 2D models of chronic AF human atrial tissue...
September 7, 2016: Medical Engineering & Physics
Edward J Ciaccio, Angelo B Biviano, Vivek Iyer, Hasan Garan
INTRODUCTION: Quantitative measurements are helpful to discern fractionated electrograms in paroxysmal and persistent atrial fibrillation (AF), and may be useful to detect optimal ablation sites. However, electrical activation events can be transient, leading to erroneous estimates of electrogram properties. Measurement of continuous changes in electrogram frequency content may improve analysis. METHOD: Fractionated local electrograms from 10 paroxysmal and 10 persistent AF patients were acquired from outside the pulmonary vein ostia and left atrial free wall using the distal bipolar ablation catheter electrode, and analyzed over continuous 16 second intervals...
September 1, 2016: Computers in Biology and Medicine
Koji Kumagai, Kentaro Minami, Daisuke Kutsuzawa, Shigeru Oshima
BACKGROUND: The endpoint of ablation procedures is suggested to be non-inducibility of paroxysmal atrial fibrillation (PAF). However, the prognosis of induced AF/atrial tachycardia (AT) after pulmonary vein isolation (PVI) in PAF patients remains unclear. METHODS: A total of 122 PAF patients were divided into the following 3 groups: Group 1, 79 without AF/AT induced after PVI; Group 2, 21 with AF/AT induced or sustained after PVI, and followed by a high-dominant frequency (DF) and continuous complex fractionated atrial electrogram (CFAE) site ablation and, if necessary, linear ablation; and Group 3, 22 with external cardioversion of AF/AT induced or sustained after PVI...
June 2016: Journal of Arrhythmia
Stavros Stavrakis, John W Dyer, Benjamin J Scherlag, Zeeshan Khan, Paul Yeung, Jawad Chohan, Sunny S Po
BACKGROUND: We aimed to develop a novel predictive marker for atrial fibrillation (AF) recurrence in patients with inducible AF after catheter ablation, based on power spectral analysis of baseline and postablation electrocardiograms. METHODS: Twenty-five patients who had undergone their first AF ablation procedure (pulmonary vein isolation and ganglionated plexi ablation) and had inducible AF after ablation were included. A 30-second interval of AF was chosen for each patient before and after ablation, and a periodogram of the atrial activity was computed...
May 26, 2016: Annals of Noninvasive Electrocardiology
Vivienne A Ezzat, Matthew J Ryan, Justin O'Leary, Cono Ariti, John Deanfield, Bejal Pandya, Shay Cullen, Fiona Walker, Fakhar Khan, Dominic J Abrams, Pier D Lambiase, Martin D Lowe
BACKGROUND: Adults with tetralogy of Fallot experience atrial tachyarrhythmias; however, there are a few data on the outcomes of radiofrequency ablation. We examined the characteristics, outcome, and predictors of recurrence of atrial tachyarrhythmias after radiofrequency ablation in tetralogy of Fallot patients. Methods/results Retrospective data were collected from 2004 to 2013. In total, 56 ablations were performed on 37 patients. We identified two matched controls per case: patients with tetralogy of Fallot but no radiofrequency ablation and not known to have atrial tachyarrhythmias...
May 26, 2016: Cardiology in the Young
Raúl Alcaraz, Fernando Hornero, José J Rieta
Atrial fibrillation (AF) is the most common arrhythmia in routine clinical practice. Despite many years of research, its mechanisms still are not well understood, thus reducing the effectiveness of AF treatments. Nowadays, pulmonary vein isolation by catheter ablation is the treatment of choice for AF resistant either to pharmacological or electrical cardioversion. However, given that long-term recurrences are common, an appropriate patient selection before the procedure is of paramount relevance in the improvement of AF catheter ablation outcome...
May 24, 2016: Annals of Biomedical Engineering
Rahul Singhal, Li-Wei Lo, Yenn-Jiang Lin Lin, Shih-Lin Chang, Yu-Feng Hu, Tze-Fan Chao, Fa-Po Chung, Cheun-Wang Chiou, Hsuan-Ming Tsao, Shih-Ann Chen
BACKGROUND: A recent study reported the close relationship between high dominant frequent (DF) sites [atrial fibrillation (AF) nest] and the intrinsic cardiac autonomic nervous system. The aim of this study was to investigate the correlation between the regional distribution of epicardial fat and the properties of the biatrial substrates in AF patients. METHODS: We studied 32 patients with paroxysmal (n = 23) and persistent (n = 9) AF. The epicardial fat volume around the left atrium (LA) was evaluated using 64-slice multidetector computed tomography and the topographic distribution of the fat volume was assessed...
March 2016: Acta Cardiol Sin
Zhaoye Zhou, Qi Jin, Lin Chen, Long Yu, Liqun Wu, Bin He
OBJECTIVE: Highest dominant-frequency (DF) drivers maintaining atrial fibrillation (AF) activities are effective ablation targets for restoring sinus rhythms in patients. This study aims to investigate whether AF drivers with highest activation rate can be noninvasively localized by means of a frequency-based cardiac electrical imaging (CEI) technique, which may aid in the planning of ablation strategy and the investigation of the underlying mechanisms of AF. METHOD: A total of 7 out of 13 patients were recorded with spontaneous paroxysmal or persistent AF and analyzed...
April 13, 2016: IEEE Transactions on Bio-medical Engineering
Omer Berenfeld, José Jalife
Atrial fibrillation (AF) is the most common cardiac arrhythmia; however, therapy is suboptimal. We review recent data on dynamics of wave propagation during AF and its mechanistic link to the substrate. Data show that the dominant frequency (DF) increase during transition to persistent AF may be explained by rotor acceleration. We discuss how translation of experimentally derived understanding of the rotors may find its way into the clinic, focusing on studies analyzing spatial distribution of DF in the atria of patients with paroxysmal versus persistent AF, and how that knowledge might contribute to improve the outcome of AF ablation procedures...
April 2016: Heart Failure Clinics
João L Salinet, Nicholas Masca, Peter J Stafford, G André Ng, Fernando S Schlindwein
BACKGROUND: Areas with high frequency activity within the atrium are thought to be 'drivers' of the rhythm in patients with atrial fibrillation (AF) and ablation of these areas seems to be an effective therapy in eliminating DF gradient and restoring sinus rhythm. Clinical groups have applied the traditional FFT-based approach to generate the three-dimensional dominant frequency (3D DF) maps during electrophysiology (EP) procedures but literature is restricted on using alternative spectral estimation techniques that can have a better frequency resolution that FFT-based spectral estimation...
2016: Biomedical Engineering Online
Minki Hwang, Jun-Seop Song, Young-Seon Lee, Changyong Li, Eun Bo Shim, Hui-Nam Pak
BACKGROUND: Although rotors have been considered among the drivers of atrial fibrillation (AF), the rotor definition is inconsistent. We evaluated the nature of rotors in 2D and 3D in- silico models of persistent AF (PeAF) by analyzing phase singularity (PS), dominant frequency (DF), Shannon entropy (ShEn), and complex fractionated atrial electrogram cycle length (CFAE-CL) and their ablation. METHODS: Mother rotor was spatiotemporally defined as stationary reentries with a meandering tip remaining within half the wavelength and lasting longer than 5 s...
2016: PloS One
Jason M Lappe, Michael J Cutler, John D Day, T Jared Bunch
Persistent atrial fibrillation (AF) is a prevalent condition that can be difficult to treat medically, and an ablation strategy is often sought. Currently, the cornerstone of AF ablation strategies is pulmonary vein isolation (PVI). Unfortunately, the single procedure success rates are limited, particularly when long-term outcomes (>1 year) are considered. As a result, the most recent consensus statement recommends that in patients with persistent AF a more extensive ablation be considered. Many additive procedural approaches to PVI have been investigated...
March 2016: Current Treatment Options in Cardiovascular Medicine
Miguel Rodrigo, Andreu M Climent, Alejandro Liberos, David Calvo, Francisco Fernández-Avilés, Omer Berenfeld, Felipe Atienza, Maria S Guillem
Burden of atrial fibrillation (AF) can be reduced by ablation of sources of electrical impulses driving AF but driver identification is still challenging. This study presents a new methodology based on causality analysis that allows identifying the hierarchically dominant areas driving AF. Identification of dominant propagation patterns was achieved by computing causal relations between intracardiac multi-electrode catheter recordings of four paroxysmal AF patients during sinus rhythm, pacing and AF. In addition, realistic mathematical models of the atria during AF were used to validate the methodology both in the presence and absence of dominant frequency (DF) gradients...
August 2016: Annals of Biomedical Engineering
Jorge Pedrón-Torrecilla, Miguel Rodrigo, Andreu M Climent, Alejandro Liberos, Esther Pérez-David, Javier Bermejo, Ángel Arenal, José Millet, Francisco Fernández-Avilés, Omer Berenfeld, Felipe Atienza, María S Guillem
INTRODUCTION: Ablation of high dominant frequency (DF) sources in patients with atrial fibrillation (AF) is an effective treatment option for paroxysmal AF. The aim of this study was to evaluate the accuracy of noninvasive estimation of DF and electrical patterns determination by solving the inverse problem of the electrocardiography. METHODS: Four representative AF patients with left-to-right and right-to-left atrial DF patterns were included in the study. For each patient, intracardiac electrograms from both atria were recorded simultaneously together with 67-lead body surface recordings...
April 2016: Journal of Cardiovascular Electrophysiology
Antonio R Hidalgo-Munoz, Ana M Tome, Decebal G Latcu, Vicente Zarzoso
Predictive models arouse increasing interest in clinical practice, not only to improve successful intervention rates but also to extract information of diverse physiological disorders. This is the case of persistent atrial fibrillation (AF), the most common cardiac arrhythmia in adults. Currently, catheter ablation (CA) is one of the preferred therapies to face this disease. However, selecting the best responders to CA by standard noninvasive techniques such as the electrocardiogram (ECG) remains a challenge...
2015: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Shiro Nakahara, Takanori Yamaguchi, Yuichi Hori, Naofumi Anjo, Akiko Hayashi, Sayuki Kobayashi, Takaaki Komatsu, Yoshihiko Sakai, Akira Fukui, Takeshi Tsuchiya, Isao Taguchi
INTRODUCTION: Atrial low-voltage zones (LVZs) may be related to maintenance of atrial fibrillation (AF). The influence of left atrial (LA) contact areas (CoAs) on reentrant or rotor-like sources maintaining AF has not been investigated. METHODS AND RESULTS: Forty patients with persistent AF (PsAF) were analyzed. Three representative CoA regions in the LA (ascending aorta: anterior wall; descending aorta: left inferior pulmonary vein; and vertebrae: posterior wall) were visualized by enhanced CT...
May 2016: Journal of Cardiovascular Electrophysiology
Rikitake Kogawa, Yasuo Okumura, Ichiro Watanabe, Masayoshi Kofune, Koichi Nagashima, Hiroaki Mano, Kazumasa Sonoda, Naoko Sasaki, Kazuki Iso, Keiko Takahashi, Kimie Ohkubo, Toshiko Nakai, Atsushi Hirayama
BACKGROUND: Complex fractionated atrial electrograms (CFAEs) and high dominant frequency (DF) are targets for atrial fibrillation (AF) ablation. Although adenosine triphosphate (ATP) is known to promote AF by shortening the atrial refractory period, its role in the pathogenesis of CFAEs and DF during AF is not fully understood. METHODS: We recorded electrical activity from a 64-electrode basket catheter placed in the left atrium (LA) of patients with paroxysmal AF (PAF, n=18) or persistent AF (PerAF, n=19) before ablation...
December 2015: Journal of Arrhythmia
Kentaro Yoshida, Kuniomi Ogata, Takeshi Inaba, Yoko Nakazawa, Yoko Ito, Iwao Yamaguchi, Akihiko Kandori, Kazutaka Aonuma
BACKGROUND: Lead V1 on electrocardiography (ECG) can detect the dominant frequency (DF) of atrial fibrillation (AF) in the right atrium (RA). Paroxysmal AF is characterized by a frequency gradient from the left atrium (LA) to the right atrium (RA). We examined the ability of magnetocardiography (MCG) to detect regional DFs in both the atria. METHODS: Study subjects comprised 18 consecutive patients referred for catheter ablation of persistent AF. An MCG system with 64 magnetic sensors was used to perform MCG in the frontal, lateral, and back planes prior to the ablation procedure in each patient...
December 2015: Journal of Arrhythmia
Hideyuki Hasebe, Kentaro Yoshida, Masataka Iida, Naoki Hatano, Toshiro Muramatsu, Kazutaka Aonuma
BACKGROUND: A left-to-right dominant frequency (DF) gradient commonly exists in paroxysmal atrial fibrillation (AF). AF initiated by right atrial (RA) ectopy (AF-RAE) is rare. OBJECTIVE: This study aimed to investigate characteristics of AF-RAE using pharmacological maneuvers and spectral analysis. METHODS: Seventy-nine consecutive patients referred for catheter ablation of paroxysmal AF were enrolled. Infusions of isoproterenol and adenosine triphosphate (ATP) were used to induce AF...
February 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Rikitake Kogawa, Yasuo Okumura, Ichiro Watanabe, Masayoshi Kofune, Koichi Nagashima, Hiroaki Mano, Kazumasa Sonoda, Naoko Sasaki, Kimie Ohkubo, Toshiko Nakai, Atsushi Hirayama
BACKGROUND: The presence of complex fractionated atrial electrograms (CFAEs) and high dominant frequencies (DFs) during atrial fibrillation (AF) have been demonstrated to be related to AF maintenance. Therefore, sequential mapping of CFAEs and DFs have been used for target sites of AF ablation. However, such mapping strategies are valid only if the CFAEs and DFs are spatiotemporally stable during the mapping procedure. We obtained spatially stable multi-electrode recordings to assess the spatiotemporal stability of CFAEs and DFs...
April 2015: Journal of Arrhythmia
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