Rotor meandering contributes to irregularity in electrograms during atrial fibrillation
Rotor meandering contributes to irregularity in electrograms during atrial fibrillation
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DOI：
10.1016/j.hrthm.2008.03.010
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发表时间：
2008-06-01
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：
Zlochiver, Sharon;Yamazaki, Masatoshi;Berenfeld, Omer
背景心房颤动（AF）的射频消融治疗最近结合了主频率（DF）和/或心电图分割的分析作为指导。然而，DF之间的关系，分馏，和时空特性的AF source.Objective我们假设，一个曲折折返AF源有助于波分馏，并反映在功率谱的局部电描记图其他地方在转子的surrounds.METHODS曲折转子作为AF源模拟在2维模型的人类心房组织和记录在离体绵羊心脏。利用奇异值分解将信号的非主导元素与主导元素区分开，从而消除与转子的DF相关的纯周期性成分（PC），从而呈现由所有其他活动组成的剩余成分（RC）。其大小与转子铁芯的尺寸和到转子铁芯的距离成比例。心外膜的光信号和电图从孤立的羊的心脏，以及人类复杂的碎裂心房electrograms，类似的分析表明，applicability of the approach.CONCLUSION增加曲折的转子驱动AF降低激活周期性，增加分馏。超出曲折区域的转子活动的频谱表现使得可以使用电极标测来表征AF源稳定性以及人类中的DF。
BACKGROUND Radiofrequency ablation therapy of atria[ fibrillation (AF) recently incorporated the analysis of dominant frequency (DF) and/or etectrogram fractionation for guidance. However, the relationships between DF, fractionation, and spatiotemporal characteristics of the AF source remain unclear.OBJECTIVE We hypothesize that a meandering reentrant AF source contributes to the wave fractionation and is reflected in the power spectrum of local electrograms elsewhere in the rotor's surroundings.METHODS Meandering rotors as AF sources were simulated in 2-dimensional models of human atrial tissue and recorded in isolated sheep hearts. Nondominant elements of the signals were differentiated from the dominant elements using singular value decomposition, whereby the purely periodic constituent (PC) relating to the rotor's DF was eliminated rendering a residual constituent (RC) that consisted of all other activity.RESULTS Spectral analysis of the decomposed constituents revealed peaks corresponding to the meandering frequency of the rotor tip, the magnitudes of which were proportional to the size of and the distance to the rotor core. Similar analyses on epicardial optical signals and electrograms from isolated sheep hearts, as well as human complex fractionated atrial electrograms, showed applicability of the approach.CONCLUSION Increased meandering of the rotor driving AF reduces activation periodicity and increases fractionation. The spectral manifestation of the rotor activity beyond the meandering region makes it possible to characterize AF source stability, as well as DF in humans using electrode mapping.