Body surface localization of left and right atrial high-frequency rotors in atrial fibrillation patients: a clinical-computational study.
Body surface localization of left and right atrial high-frequency rotors in atrial fibrillation patients: a clinical-computational study.
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DOI：
10.1016/j.hrthm.2014.05.013
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发表时间：
2014-09
期刊：
影响因子：
5.5
通讯作者：
Berenfeld, Omer
中科院分区：
文献类型：
--
作者：
Rodrigo, Miguel;Guillem, Maria S.;Climent, Andreu M.;Pedron-Torrecilla, Jorge;Liberos, Alejandro;Millet, Jose;Fernandez-Aviles, Francisco;Atienza, Felipe;Berenfeld, Omer
消融是一种有效的治疗心房颤动（AF）患者的电驱动可以确定。本研究的目的是提出和讨论一种新的严格无创的方法来绘制和识别心房区域负责房颤的延续。使用67导联记录系统记录14例房颤患者的表面电位。在最高主导频率（HDF）下进行带通滤波后，在表面相位图中识别出奇异点（SPs）。建立了心房和躯体组合的数学模型，并用于研究表面相位图估计心房壁转子活动的能力。模拟结果表明，表面电位起源于心房电位，但并非所有心房电位都反射到表面。在未过滤和hdf过滤的患者数据中，稳定的SPs分别在8.3%±5.7%和73.1%±16.8%的时间内出现在AF信号中（P < 0.01）。每个旋转模式的平均持续时间在未滤波时也低于hdf滤波后的AF信号（160±43 ms vs 342±138 ms; P < 0.01），导致每个转子2.8±0.7转。带通滤波通过降低不同频率心房电活动的影响，减少了表面HDF转子的明显弯曲。代表心房颤动时HDF旋翼的躯干表面SPs反射在心房最快位置对应的特定区域。心房颤动过程中HDF滤波后的表面电位信号相位分析显示，重入驱动器定位于左心房或右心房，有助于定位消融目标。
Ablation is an effective therapy in patients with atrial fibrillation (AF) in which an electrical driver can be identified. The aim of this study was to present and discuss a novel and strictly noninvasive approach to map and identify atrial regions responsible for AF perpetuation. Surface potential recordings of 14 patients with AF were recorded using a 67-lead recording system. Singularity points (SPs) were identified in surface phase maps after band-pass filtering at the highest dominant frequency (HDF). Mathematical models of combined atria and torso were constructed and used to investigate the ability of surface phase maps to estimate rotor activity in the atrial wall. The simulations show that surface SPs originate at atrial SPs, but not all atrial SPs are reflected at the surface. Stable SPs were found in AF signals during 8.3% ± 5.7% vs 73.1% ± 16.8% of the time in unfiltered vs HDF-filtered patient data, respectively (P < .01). The average duration of each rotational pattern was also lower in unfiltered than in HDF-filtered AF signals (160 ± 43 ms vs 342 ± 138 ms; P < .01), resulting in 2.8 ± 0.7 rotations per rotor. Band-pass filtering reduced the apparent meandering of surface HDF rotors by reducing the effect of the atrial electrical activity occurring at different frequencies. Torso surface SPs representing HDF rotors during AF were reflected at specific areas corresponding to the fastest atrial location. Phase analysis of surface potential signals after HDF filtering during AF shows reentrant drivers localized to either the left atrium or the right atrium, helping in localizing ablation targets.
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影响因子：
24
作者：
Narayan, Sanjiv M.;Krummen, David E.;Miller, John M.
通讯作者：
Miller, John M.
影响因子：
105.7
作者：
Lewis, T
通讯作者：
Lewis, T
DOI：
10.1111/j.1540-8167.2008.01356.x
发表时间：
2009-05-01
影响因子：
2.7
作者：
Guillem, Maria S.;Climent, Andreu M.;Bollmann, Andreas
通讯作者：
Bollmann, Andreas
影响因子：
5.5
作者：
Zlochiver, Sharon;Yamazaki, Masatoshi;Berenfeld, Omer
通讯作者：
Berenfeld, Omer
影响因子：
37.8
作者：
Atienza, Felipe;Almendral, Jesus;Berenfeld, Omer
通讯作者：
Berenfeld, Omer