Published January 10, 2022 | Version v1
Conference paper Open

Spatial Relationship Between Atrial Fibrillation Drivers and the Presence of Repetitive Conduction Patterns Using Recurrence Analysis on In-Silico Models

  • 1. Physiology Department, Maastricht University, Maastricht, Netherlands
  • 2. Center for Computational Medicine in Cardiology, Euler Institute, Universit`a della Svizzera Italiana, Lugano, Switzerland
  • 3. Department of Data Science and Knowledge Engineering, Maastricht University, Maastricht, Netherlands

Description

Catheter ablation treatment for atrial fibrillation (AF)
is still suboptimal, possibly due to the difficulty to identify
AF drivers. Recurrence analysis can be used to detect and
eventually locate repetitive patterns that tend to be generated
by AF drivers. In this study, we aimed to understand
the spatial relationship between repetitiveness in recurrence
analysis and rotor positions in an in-silico AF model.
AF was simulated in a detailed three-dimensional model of
the atria considering different degrees of endomysial fibrosis
(0% and 70%). Rotors driving AF were tracked based
on phase singularities obtained from transmembrane potentials.
Activation-phase signals calculated from electrograms
(4x4 electrode grid, 3 mm spacing) were used
for recurrence analysis. Intervals with and without longlasting
sources inside the electrode coverage area were determined;
the recurrence in both groups of intervals was
quantified and compared with each other by calculating
the recurrence rate (RR) per AF cycle length. RRs were
lower during intervals with sources for both 0% and 70%
fibrosis groups (0.56 [0.36;0.85] vs. 0.90 [0.80;0.97],
p < 0:001 and 0.73 [0.41;0.84] vs. 0.87 [0.76;0.92],
p < 0:001, respectively). These results indicate that recurrences
are found in the area adjacent to the sources but
not on the sources themselves, thus suggesting that recurrence
analysis could contribute to guide ablation therapy.

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Additional details

Funding

PersonalizeAF – Personalized Therapies for Atrial Fibrillation. A Translational Approach 860974
European Commission