Bhupesh Pathik1, Jonathan M Kalman1, Tomos Walters1, Pawel Kuklik2, Jichao Zhao3, Andrew Madry4, Prashanthan Sanders5, Peter M Kistler6, Geoffrey Lee7. 1. Royal Melbourne Hospital, Parkville, Victoria, Australia; University of Melbourne, Parkville, Victoria, Australia. 2. University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 3. Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand. 4. Royal Melbourne Hospital, Parkville, Victoria, Australia. 5. Royal Adelaide Hospital, University of Adelaide, Adelaide, South Australia, Australia. 6. University of Melbourne, Parkville, Victoria, Australia; Alfred Hospital and Baker IDI, Melbourne, Victoria, Australia. 7. Royal Melbourne Hospital, Parkville, Victoria, Australia; University of Melbourne, Parkville, Victoria, Australia. Electronic address: geoff.lee@mh.org.au.
Abstract
BACKGROUND: Current phase mapping systems for atrial fibrillation create 2-dimensional (2D) maps. This process may affect the accurate detection of rotors. We developed a 3-dimensional (3D) phase mapping technique that uses the 3D locations of basket electrodes to project phase onto patient-specific left atrial 3D surface anatomy. OBJECTIVE: We sought to determine whether rotors detected in 2D phase maps were present at the corresponding time segments and anatomical locations in 3D phase maps. METHODS: One-minute left atrial atrial fibrillation recordings were obtained in 14 patients using the basket catheter and analyzed off-line. Using the same phase values, 2D and 3D phase maps were created. Analysis involved determining the dominant propagation patterns in 2D phase maps and evaluating the presence of rotors detected in 2D phase maps in the corresponding 3D phase maps. RESULTS: Using 2D phase mapping, the dominant propagation pattern was single wavefront (36.6%) followed by focal activation (34.0%), disorganized activity (23.7%), rotors (3.3%), and multiple wavefronts (2.4%). Ten transient rotors were observed in 9 of 14 patients (64%). The mean rotor duration was 1.1 ± 0.7 seconds. None of the 10 rotors observed in 2D phase maps were seen at the corresponding time segments and anatomical locations in 3D phase maps; 4 of 10 corresponded with single wavefronts in 3D phase maps, 2 of 10 with 2 simultaneous wavefronts, 1 of 10 with disorganized activity, and in 3 of 10 there was no coverage by the basket catheter at the corresponding 3D anatomical location. CONCLUSION: Rotors detected in 2D phase maps were not observed in the corresponding 3D phase maps. These findings may have implications for current systems that use 2D phase mapping.
BACKGROUND: Current phase mapping systems for atrial fibrillation create 2-dimensional (2D) maps. This process may affect the accurate detection of rotors. We developed a 3-dimensional (3D) phase mapping technique that uses the 3D locations of basket electrodes to project phase onto patient-specific left atrial 3D surface anatomy. OBJECTIVE: We sought to determine whether rotors detected in 2D phase maps were present at the corresponding time segments and anatomical locations in 3D phase maps. METHODS: One-minute left atrial atrial fibrillation recordings were obtained in 14 patients using the basket catheter and analyzed off-line. Using the same phase values, 2D and 3D phase maps were created. Analysis involved determining the dominant propagation patterns in 2D phase maps and evaluating the presence of rotors detected in 2D phase maps in the corresponding 3D phase maps. RESULTS: Using 2D phase mapping, the dominant propagation pattern was single wavefront (36.6%) followed by focal activation (34.0%), disorganized activity (23.7%), rotors (3.3%), and multiple wavefronts (2.4%). Ten transient rotors were observed in 9 of 14 patients (64%). The mean rotor duration was 1.1 ± 0.7 seconds. None of the 10 rotors observed in 2D phase maps were seen at the corresponding time segments and anatomical locations in 3D phase maps; 4 of 10 corresponded with single wavefronts in 3D phase maps, 2 of 10 with 2 simultaneous wavefronts, 1 of 10 with disorganized activity, and in 3 of 10 there was no coverage by the basket catheter at the corresponding 3D anatomical location. CONCLUSION: Rotors detected in 2D phase maps were not observed in the corresponding 3D phase maps. These findings may have implications for current systems that use 2D phase mapping.
Authors: Shu Meng; Judit Chamorro-Servent; Nicholas Sunderland; Jichao Zhao; Laura R Bear; Nigel A Lever; Gregory B Sands; Ian J LeGrice; Anne M Gillis; David M Budgett; Bruce H Smaill Journal: Front Physiol Date: 2022-07-07 Impact factor: 4.755