TY - JOUR
T1 - The inspection paradox
T2 - An important consideration in the evaluation of rotor lifetimes in cardiac fibrillation
AU - Jenkins, Evan V.
AU - Dharmaprani, Dhani
AU - Schopp, Madeline
AU - Quah, Jing Xian
AU - Tiver, Kathryn
AU - Mitchell, Lewis
AU - Xiong, Feng
AU - Aguilar, Martin
AU - Pope, Kenneth
AU - Akar, Fadi G.
AU - Roney, Caroline H.
AU - Niederer, Steven A.
AU - Nattel, Stanley
AU - Nash, Martyn P.
AU - Clayton, Richard H.
AU - Ganesan, Anand N.
N1 - Funding Information:
This work was supported by the National Health and Medical Research Council of Australia Ideas Grant (No. 2010522) and the National Heart Foundation of Australia (No. 101188).
Publisher Copyright:
Copyright © 2022 Jenkins, Dharmaprani, Schopp, Quah, Tiver, Mitchell, Xiong, Aguilar, Pope, Akar, Roney, Niederer, Nattel, Nash, Clayton and Ganesan.
PY - 2022/9/6
Y1 - 2022/9/6
N2 - Background and Objective: Renewal theory is a statistical approach to model the formation and destruction of phase singularities (PS), which occur at the pivots of spiral waves. A common issue arising during observation of renewal processes is an inspection paradox, due to oversampling of longer events. The objective of this study was to characterise the effect of a potential inspection paradox on the perception of PS lifetimes in cardiac fibrillation. Methods: A multisystem, multi-modality study was performed, examining computational simulations (Aliev-Panfilov (APV) model, Courtmanche-Nattel model), experimentally acquired optical mapping Atrial and Ventricular Fibrillation (AF/VF) data, and clinically acquired human AF and VF. Distributions of all PS lifetimes across full epochs of AF, VF, or computational simulations, were compared with distributions formed from lifetimes of PS existing at 10,000 simulated commencement timepoints. Results: In all systems, an inspection paradox led towards oversampling of PS with longer lifetimes. In APV computational simulations there was a mean PS lifetime shift of +84.9% (95% CI, ± 0.3%) (p < 0.001 for observed vs overall), in Courtmanche-Nattel simulations of AF +692.9% (95% CI, ±57.7%) (p < 0.001), in optically mapped rat AF +374.6% (95% CI, (Formula presented.) 88.5%) (p = 0.052), in human AF mapped with basket catheters +129.2% (95% CI, ±4.1%) (p < 0.05), human AF-HD grid catheters 150.8% (95% CI, (Formula presented.) 9.0%) (p < 0.001), in optically mapped rat VF +171.3% (95% CI, ±15.6%) (p < 0.001), in human epicardial VF 153.5% (95% CI, ±15.7%) (p < 0.001). Conclusion: Visual inspection of phase movies has the potential to systematically oversample longer lasting PS, due to an inspection paradox. An inspection paradox is minimised by consideration of the overall distribution of PS lifetimes.
AB - Background and Objective: Renewal theory is a statistical approach to model the formation and destruction of phase singularities (PS), which occur at the pivots of spiral waves. A common issue arising during observation of renewal processes is an inspection paradox, due to oversampling of longer events. The objective of this study was to characterise the effect of a potential inspection paradox on the perception of PS lifetimes in cardiac fibrillation. Methods: A multisystem, multi-modality study was performed, examining computational simulations (Aliev-Panfilov (APV) model, Courtmanche-Nattel model), experimentally acquired optical mapping Atrial and Ventricular Fibrillation (AF/VF) data, and clinically acquired human AF and VF. Distributions of all PS lifetimes across full epochs of AF, VF, or computational simulations, were compared with distributions formed from lifetimes of PS existing at 10,000 simulated commencement timepoints. Results: In all systems, an inspection paradox led towards oversampling of PS with longer lifetimes. In APV computational simulations there was a mean PS lifetime shift of +84.9% (95% CI, ± 0.3%) (p < 0.001 for observed vs overall), in Courtmanche-Nattel simulations of AF +692.9% (95% CI, ±57.7%) (p < 0.001), in optically mapped rat AF +374.6% (95% CI, (Formula presented.) 88.5%) (p = 0.052), in human AF mapped with basket catheters +129.2% (95% CI, ±4.1%) (p < 0.05), human AF-HD grid catheters 150.8% (95% CI, (Formula presented.) 9.0%) (p < 0.001), in optically mapped rat VF +171.3% (95% CI, ±15.6%) (p < 0.001), in human epicardial VF 153.5% (95% CI, ±15.7%) (p < 0.001). Conclusion: Visual inspection of phase movies has the potential to systematically oversample longer lasting PS, due to an inspection paradox. An inspection paradox is minimised by consideration of the overall distribution of PS lifetimes.
KW - atrial fibrilation
KW - cardiac fibrillation
KW - inspection paradox
KW - phase singularity
KW - renewal theory
KW - ventricular fibrillation
UR - http://www.scopus.com/inward/record.url?scp=85138426431&partnerID=8YFLogxK
U2 - 10.3389/fphys.2022.920788
DO - 10.3389/fphys.2022.920788
M3 - Article
AN - SCOPUS:85138426431
SN - 1664-042X
VL - 13
JO - Frontiers in Physiology
JF - Frontiers in Physiology
M1 - 920788
ER -