Computational Analysis of Mapping Catheter Geometry and Contact Quality Effects on Rotor Detection in Atrial Fibrillation

Figures

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  FIGURE 1. Representation of the simulated catheters [the HD Grid (A) and the PentaRay (B)] superimposed to the simulated electrical propagation on the atrial tissue in one-time frame. Each electrode is represented with a red dot.

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  FIGURE 2. Simulated EGM signals. (A) Computational configuration with the 16 electrodes of the 3 mm HD Grid catheter. Electrodes for which the EGM signals are displayed are in different colors. (B) The simulated EGM signals are shown between 1 and 2 s of simulation. Electrodes and the corresponding EGMs are coded with the same color.

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  FIGURE 3. Density maps of rotor tip trajectory reconstructed with an inter-electrode distance of 3 mm, with a 4 × 4 HD Grid catheter at different distances from the atrial wall. (A) Ground truth; (B) 3 mm HD Grid catheter in contact; (C) 3 mm HD Grid catheter at 1 mm from the wall; (D) 3 mm HD Grid catheter at 2 mm from the wall; (E) 3 mm HD Grid catheter at 3 mm from the wall. The patch has been zoomed (x-axis between 10 and 40 mm, y-axis between 0 and 30 mm). Color encodes the trajectory density value. (F–I) The phase activation (gray line) and EGM signal (black line) for the 4 central electrodes (n. 6-7-10-11) are reported under each simulated configuration at the same time frame. The white diamond marker represents the rotor tip position of the ground truth.

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  FIGURE 4. Density maps of rotor tip trajectory reconstructed with an inter-electrode distance of 6 mm, with a 4 × 4 HD Grid catheter at different distances from the atrial wall. (A) Ground truth; (B) 6 mm HD Grid catheter in contact; (C) 6 mm HD Grid catheter at 1 mm from the wall; (D) 6 mm HD Grid catheter at 2 mm from the wall; (E) 6 mm HD Grid catheter at 3 mm from the wall. The patch has been zoomed (x-axis between 10 and 40 mm, y-axis between 0 and 30 mm). Color encodes the trajectory density value. (F–I) The phase activation (gray line) and EGM signal (black line) for the 4 central electrodes (n. 6-7-10-11) are reported under each simulated configuration at the same time frame. The white diamond marker represents the rotor tip position of the ground truth.

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  FIGURE 5. Density maps of rotor tip trajectory reconstructed by the algorithm with an inter-electrode distance of 3 mm with a 6 × 6 layout of the HD Grid catheter. (A) Ground truth; (B) 3 mm 6 × 6 HD Grid catheter in contact. The patch has been zoomed (x-axis between 10 and 40 mm, y-axis between 0 and 30 mm). Color encodes the trajectory density value. The white diamond marker represents the rotor tip position of the ground truth.

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  FIGURE 6. Density maps of rotor tip trajectory reconstructed by the 4-4-4 PentaRay catheter at different distances from the atrial wall. (A) Ground truth; (B) PentaRay catheter in contact; (C) PentaRay catheter at 1 mm from the wall; (D) PentaRay catheter at 2 mm from the wall; (E) PentaRay catheter at 3 mm from the wall. The patch has been zoomed (x-axis between 10 and 40 mm, y-axis between 0 and 30 mm). Color encodes the trajectory density value. (F–I) The phase activation (gray line) and EGM signal (black line) for the central electrodes (n. 15-16-17-18-19) are reported under each simulated configuration at the same time frame. The white diamond marker represents the rotor tip position of the ground truth.

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  FIGURE 7. Density maps of rotor tip trajectory reconstructed by the 2-2-2 PentaRay catheter at different distances from the atrial wall. (A) Ground truth; (B) PentaRay catheter in contact; (C) PentaRay catheter at 1 mm from the LA wall; (D) PentaRay catheter at 2 mm from the LA wall; (E) PentaRay catheter at 3 mm from the LA wall. The patch has been zoomed (x-axis between 10 and 40 mm, y-axis between 0 and 30 mm). Color encodes the trajectory density value. (F–I) The phase activation (gray line) and EGM signal (black line) for the central electrodes (n. 16-17-18-19-20) are reported under each simulated configuration at the same time frame. The white diamond marker represents the rotor tip position of the ground truth.

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  FIGURE 8. Density maps of rotor tip trajectory reconstructed in the shifted tests. (A) 4 × 4 HD Grid catheter with an inter-electrode distance of 3 mm and a positive shift of 1.5 mm on the right; (B) 4 × 4 HD Grid catheter with an inter-electrode distance of 3 mm and a positive shift of 3 mm on the right; (C) 4-4-4 PentaRay catheter with a right shift of 5 mm; (D) 4-4-4 PentaRay catheter with a right shift of 8 mm. The patch has been zoomed (x-axis between 10 and 40 mm, y-axis between 0 and 30 mm). Color encodes the trajectory density value. The white diamond marker represents the rotor tip position of the ground truth.

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  FIGURE 9. Density maps of rotor tip trajectory reconstructed in the no-contact electrodes conditions. (A) 4 × 4 HD Grid catheter with an inter-electrode distance of 3 mm: the external splines are in contact (light gray) while the central splines are at a distance of 1 mm from the wall (dark gray color); (B) 4 × 4 HD Grid catheter with an inter-electrode distance of 3 mm: the central splines are in contact (light gray) while the external splines are at a distance of 1 mm from the wall (dark gray); (C) 4 × 4 HD Grid catheter with an inter-electrode distance of 3 mm: the two left splines are in contact (light gray) while the other two splines are at increase distance of 2 (dark gray) and 3 mm from the wall (dark), respectively; (D) 4-4-4 PentaRay catheter: the central ring is at a distance of 1 mm from the wall (dark gray); (E) 4-4-4 PentaRay catheter: the two central rings are at increase distance of 2 mm (dark gray) and 3 mm from the wall (dark), respectively. The patch has been zoomed (x-axis between 10 and 40 mm, y-axis between 0 and 30 mm). Color encodes the trajectory density value. The white diamond marker represents the rotor tip position of the ground truth.

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  FIGURE 10. Real atrial shape (light red) from a patient acquired during ablation on which we have tested the proposed framework. The 3D region covered by the catheter (black points) is represented by the tissue in which the voltage was simulated. Our framework was able to detect correctly the rotor tip (duration of the detected rotor 7.75 s, mean distance between ground truth and detected rotor tip 2 mm).