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Rotor Tracking Using Phase of Electrograms Recorded During Atrial Fibrillation

Research output: Contribution to journalArticle

Caroline Helen Roney, Chris D Cantwell, Norman A Qureshi, Rasheda A. Chowdhury, Emmanuel Dupont, Phang Boon Lim, Edward J Vigmond, Jennifer H Tweedy, Fu Siong Ng, Nicholas S Peters

Original languageEnglish
Pages (from-to)910-923
JournalAnnals of Biomedical Engineering
Volume45
Issue number4
Published1 Apr 2017

Documents

  • ABME_Roney_2017

    10.1007_s10439_016_1766_4_2.pdf, 3.36 MB, application/pdf

    Uploaded date:03 Jun 2018

    Version:Final published version

    Licence:CC BY

King's Authors

Abstract

Extracellular electrograms recorded during atrial fibrillation (AF) are challenging to interpret due to the inherent beat-to-beat variability in amplitude and duration. Phase mapping represents these voltage signals in terms of relative position within the cycle, and has been widely applied to action potential and unipolar electrogram data of myocardial fibrillation. To date, however, it has not been applied to bipolar recordings, which are commonly acquired clinically. The purpose of this study is to present a novel algorithm for calculating phase from both unipolar and bipolar electrograms recorded during AF. A sequence of signal filters and processing steps are used to calculate phase from simulated, experimental, and clinical, unipolar and bipolar electrograms. The algorithm is validated against action potential phase using simulated data (trajectory centre error <0.8 mm); between experimental multi-electrode array unipolar and bipolar phase; and for wavefront identification in clinical atrial tachycardia. For clinical AF, similar rotational content (R 2 = 0.79) and propagation maps (median correlation 0.73) were measured using either unipolar or bipolar recordings. The algorithm is robust, uses standard signal processing techniques, and accurately quantifies AF wavefronts and sources. Identifying critical sources, such as rotors, in AF, may allow for more accurate targeting of ablation therapy and improved patient outcomes.

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