Technical Considerations on Phase Mapping for Identification of Atrial Reentrant Activity in Direct- and Inverse-Computed Electrograms
Technical Considerations on Phase Mapping for Identification of Atrial Reentrant Activity in Direct- and Inverse-Computed Electrograms
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DOI：
10.1161/circep.117.005008
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发表时间：
2017-09-01
影响因子：
8.4
通讯作者：
Guillem, Maria S.
中科院分区：
文献类型：
--
作者：
Rodrigo, Miguel;Climent, Andreu M.;Guillem, Maria S.
背景：相位标测已成为一种广泛使用的技术，用于识别心房折返环路，以指导消融治疗。这项工作研究的相位映射过程中，信号的性质和过滤如何影响的折返模式表征电描记图（EGM），体表电位映射，心电图imaging signals.METHODS和RESULTS：EGM，体表电位映射，和心电图成像相位图，从17模拟心房颤动，心房扑动，局灶性房性心动过速。通过原始信号和最高主频（HDF）窄带通滤波后的信号中的奇点识别来识别折返活性。仅房颤和某些房扑传播模式的EGM记录中主要存在折返活动，HDF滤波允许在单极记录中将房颤中的折返活动检测时间从60%增加到70%，在双极记录中从0%增加到62%。在体表电位标测图中，HDF滤波将灵敏度从10%增加到90%，尽管引起了约30%时间的残留假折返活动。在心电图成像中，允许HDF滤波增加
BACKGROUND: Phase mapping has become a broadly used technique to identify atrial reentrant circuits for ablative therapy guidance. This work studies the phase mapping process and how the signal nature and its filtering affect the reentrant pattern characterization in electrogram (EGM), body surface potential mapping, and electrocardiographic imaging signals.METHODS AND RESULTS: EGM, body surface potential mapping, and electrocardiographic imaging phase maps were obtained from 17 simulations of atrial fibrillation, atrial flutter, and focal atrial tachycardia. Reentrant activity was identified by singularity point recognition in raw signals and in signals after narrow band-pass filtering at the highest dominant frequency (HDF). Reentrant activity was dominantly present in the EGM recordings only for atrial fibrillation and some atrial flutter propagations patterns, and HDF filtering allowed increasing the reentrant activity detection from 60% to 70% of time in atrial fibrillation in unipolar recordings and from 0% to 62% in bipolar. In body surface potential mapping maps, HDF filtering increased from 10% to 90% the sensitivity, although provoked a residual false reentrant activity approximate to 30% of time. In electrocardiographic imaging, HDF filtering allowed to increase