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September 1, 2017Circulation Arrhythmia and ElectrophysiologyOpen Access

Technical Considerations on Phase Mapping for Identification of Atrial Reentrant Activity in Direct- and Inverse-Computed Electrograms

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Key result

HDF filtering boosts rotor detection sensitivity to ~90% but reduces specificity versus raw unipolar EGMs.

  • n=17

Why the study?

Does HDF filtering improve the detection of atrial reentrant activity in electrograms and electrocardiographic imaging compared to raw signals in simulations?

Population

17 simulations of atrial fibrillation, atrial flutter, and focal atrial tachycardia

Comparison

Phase mapping with narrow band-pass filtering at… vs Phase mapping on raw signals

Design

Preclinical

Authors

MRMiguel RodrigoUniversitat de ValènciaACAndreu M. ClimentAdif (Spain)ALAlejandro LiberosUniversitat de València

Discussion

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Implication

Raw unipolar EGMs accurately detect rotors without filtering; leaves open HDF utility for bipolar EGMs and BSPM pending validation.

Structured PICO

Does HDF filtering improve the detection of atrial reentrant activity in electrograms and electrocardiographic imaging compared to raw signals in simulations?

P
Population
17 simulations of atrial fibrillation, atrial flutter, and focal atrial tachycardia evaluating phase mapping techniques.
I
Intervention
Phase mapping with narrow band-pass filtering at the highest dominant frequency (HDF)
C
Comparator
Phase mapping on raw signals
O
Outcome
Reentrant activity detection (rotor identification) accuracy and sensitivitysurrogate

Rotor identification is accurate in unipolar EGMs without additional processing, whereas bipolar EGMs and body surface potential mapping require HDF filtering at the cost of decreased specificity.

Cite This Study

Rodrigo et al. (2017) studied Atrial fibrillation, atrial flutter, and focal atrial tachycardia (n=17). Highest dominant frequency (HDF) filtering vs. Raw signals was evaluated on Reentrant activity detection. HDF filtering increased rotor detection sensitivity in bipolar EGMs (0% to 62%) and body surface potential mapping (10% to 90%) but decreased specificity, whereas raw unipolar EGMs were accurate.

synapsesocial.com/papers/6aa4ec1dc60d4c81533d61cbhttps://doi.org/10.1161/circep.117.005008

Topics

Atrial fibrillationPersistent AF managementAF ablation outcomes
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Methodology Considerations in Phase Mapping of Human Cardiac Arrhythmias2016 · 87 citations
  2. 2Identification of Rotors during Human Atrial Fibrillation Using Contact Mapping and Phase Singularity Detection: Technical Considerations2016 · 97 citations
  3. 3Noninvasive Estimation of Epicardial Dominant High‐Frequency Regions During Atrial Fibrillation2016 · 59 citations
  4. 4Two Independent Mapping Techniques Identify Rotational Activity Patterns at Sites of Local Termination During Persistent Atrial Fibrillation2017 · 50 citations
  5. 5Noninvasive Localization of Maximal Frequency Sites of Atrial Fibrillation by Body Surface Potential Mapping2013 · 136 citations