Noninvasive 67-lead body surface mapping significantly correlated with intracardiac dominant frequencies for the right (ρ=0.96) and left (ρ=0.92) atria in patients with atrial fibrillation.
Observational (n=14)
Does spectral analysis of 67-lead body surface recordings accurately identify maximal frequency sites of atrial fibrillation compared to invasive endocardial electrograms in patients with a history of AF?
Spectral analysis of body surface recordings during atrial fibrillation allows noninvasive characterization of atrial dominant frequencies, correlating highly with invasive endocardial mapping.
Effect estimate: ρ=0.96 (right atrium), ρ=0.92 (left atrium), ρ=0.93 (DF gradient)
BACKGROUND: Ablation of high-frequency sources in patients with atrial fibrillation (AF) is an effective therapy to restore sinus rhythm. However, this strategy may be ineffective in patients without a significant dominant frequency (DF) gradient. The aim of this study was to investigate whether sites with high-frequency activity in human AF can be identified noninvasively, which should help intervention planning and therapy. METHODS AND RESULTS: In 14 patients with a history of AF, 67-lead body surface recordings were simultaneously registered with 15 endocardial electrograms from both atria including the highest DF site, which was predetermined by atrial-wide real-time frequency electroanatomical mapping. Power spectra of surface leads and the body surface location of the highest DF site were compared with intracardiac information. Highest DFs found on specific sites of the torso showed a significant correlation with DFs found in the nearest atrium (ρ=0.96 for right atrium and ρ=0.92 for left atrium) and the DF gradient between them (ρ=0.93). The spatial distribution of power on the surface showed an inverse relationship between the frequencies versus the power spread area, consistent with localized fast sources as the AF mechanism with fibrillatory conduction elsewhere. CONCLUSIONS: Spectral analysis of body surface recordings during AF allows a noninvasive characterization of the global distribution of the atrial DFs and the identification of the atrium with the highest frequency, opening the possibility for improved noninvasive personalized diagnosis and treatment.
Guillem et al. (Wed,) conducted a observational in Atrial fibrillation (n=14). 67-lead body surface recordings vs. 15 endocardial electrograms was evaluated on Correlation of highest dominant frequencies (DFs) on the torso with DFs in the nearest atrium (ρ=0.96 (right atrium), ρ=0.92 (left atrium), ρ=0.93 (DF gradient)). Noninvasive 67-lead body surface mapping significantly correlated with intracardiac dominant frequencies for the right (ρ=0.96) and left (ρ=0.92) atria in patients with atrial fibrillation.