Electrographic flow mapping for atrial fibrillation: theoretical basis and preliminary observations

David E. Haines*, Melissa H. Kong, Peter Ruppersberg, Philip Haeusser, Boaz Avitall, Tamas Szili Torok, Atul Verma*

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

8 Citations (Web of Science)
26 Downloads (Pure)

Abstract

Ablation strategies remain poorly defined for persistent atrial fibrillation (AF) patients with recurrence despite intact pulmonary vein isolation (PVI). As the ability to perform durable PVI improves, the need for advanced mapping to identify extra-PV sources of AF becomes increasingly evident. Multiple mapping technologies attempt to localize these self-sustained triggers and/or drivers responsible for initiating and/or maintaining AF; however, current approaches suffer from technical limitations. Electrographic flow (EGF) mapping is a novel mapping method based on well-established principles of optical flow and fluid dynamics. It enables the full spatiotemporal reconstruction of organized wavefront propagation within the otherwise chaotic and disorganized electrical conduction of AF. Given the novelty of EGF mapping and relative unfamiliarity of most clinical electrophysiologists with the mathematical principles powering the EGF algorithm, this paper provides an in-depth explanation of the technical/mathematical foundations of EGF mapping and demonstrates clinical applications of EGF mapping data and analyses. Graphical abstract: Starting with a 64-electrode basket catheter, unipolar EGMs are recorded and processed using an algorithm to visualize the electrographic flow and highlight the location of high prevalence AF “source” activity. The AF sources are agnostic to the specific mechanisms of source signal generation. [Figure not available: see fulltext.]

Original languageEnglish
Pages (from-to)1015-1028
Number of pages14
JournalJournal of Interventional Cardiac Electrophysiology
Volume66
Issue number4
Early online date15 Aug 2022
DOIs
Publication statusPublished - Jun 2023

Bibliographical note

Funding Information:
We appreciate the contribution of clinical data from Dr. Andreas Rillig toward the production of this manuscript.

Publisher Copyright:
© 2022, The Author(s).

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