An Evaluation of Phase Analysis to Interpret Atrial Activation Patterns during Persistent Atrial Fibrillation for Targeted Ablation.
An Evaluation of Phase Analysis to Interpret Atrial Activation Patterns during Persistent Atrial Fibrillation for Targeted Ablation.
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DOI：
10.3390/jcm11195807
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发表时间：
2022-09-30
影响因子：
3.9
通讯作者：
Waldo AL
中科院分区：
文献类型：
--
作者：
Lee S;Khrestian CM;Sahadevan J;Waldo AL
背景：相位分析已用于识别和定位心房颤动 (AF) 源，以进行针对性消融。我们之前证明，重复的想要再入（不完全再入）通常会使用相位分析产生明显稳定的转子。使用心房电图（AEG）进行相位分析所引起的误解可能是由于在从AEG转换的瞬时相位波形中检测到不准确的相位反转（π到-π）时间点而导致的。本研究的目的是评估相位分析的准确性，以检测持续性和长期持续性（LSP）房颤患者房颤高密度图记录的心房激动。方法和结果：在心脏直视手术期间，我们使用 512 个电极同时记录了 7 名持续性和 LSP AF 患者的双心房激活情况。将相位分析与 4 秒数据期间的手动测量进行比较。为了保证激活序列图的准确性，成功的记录位点被定义为在 4 秒内具有≤4 个不匹配的激活时间。在所有 AF 发作中，由于激活时间差异 (14.7%)、感测不足 (2.7%) 或感测过度 (0.6%)，相位分析的准确度仅为激活次数总数的 82%。通过相位分析，只有 67.9% 的记录点满足成功记录点的要求。在不成功的记录位点中，AEG的特征是相对不规则的周期长度（CL）、复杂的AEG和双电位AEG。结论：在具有相对不规则 CL、复杂 AEG 或双电位 AEG 的记录位点中，相位分析不太准确。因此，时相分析可能会导致对 AF 期间心房激动模式的误解。在执行目标消融之前，需要对原始 AEG 进行目视检查，以确认相位分析检测到的 AF 源。
Background: Phase analysis has been used to identify and localize atrial fibrillation (AF) sources for targeted ablation. We previously demonstrated that repetitive wannabe reentry (incomplete reentry) often generated an apparent stable rotor using phase analysis. The misinterpretation caused by phase analysis using atrial electrograms (AEGs) may result from detecting inaccurate time points at phase inversion (π to −π) in the instantaneous phase waveform converted from AEG. The purpose of this study was to evaluate the accuracy of phase analysis to detect atrial activations recorded from the high-density mapping of AF in patients with persistent and long-standing persistent (LSP) AF. Methods and Results: During open heart surgery, we recorded activation from both atria simultaneously using 512 electrodes in 7 patients with persistent and LSP AF. The phase analysis was compared to manual measurements during 4 s of data. For the accuracy of activation sequence maps, a successful recording site was defined as having ≤4 mismatched activation times during the 4 s. In all AF episodes, the accuracy of the phase analysis was only 82% of the total number of activation times due to either activation time differences (14.7%), under-sensing (2.7%), or over-sensing (0.6%). Only 67.9% of the total recording sites met the requirement of a successful recording site by phase analysis. In unsuccessful recording sites, AEG characteristics were relatively irregular cycle length (CL), complex AEG, and double potential AEG. Conclusion: The phase analysis was less accurate in recording sites with a relatively irregular CL, complex AEG, or double potential AEG. As a result, phase analysis may lead to the misinterpretation of atrial activation patterns during AF. A visual review of the original AEG is needed to confirm the detected AF sources of phase analysis before performing targeted ablation.
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稳定转子或焦点源的直接或巧合消除可能解释了成功的房颤消融：确认试验的对治疗分析（对AF的常规消融有或没有局灶性脉冲脉冲和转子调制）。
影响因子：
24
作者：
Narayan, Sanjiv M.;Krummen, David E.;Clopton, Paul;Shivkumar, Kalyanam;Miller, John M.
通讯作者：
Miller, John M.
影响因子：
8.4
作者：
Podziemski, Piotr;Zeemering, Stef;Schotten, Ulrich
通讯作者：
Schotten, Ulrich
影响因子：
24
作者：
Jadidi, Amir S.;Cochet, Hubert;Jais, Pierre
通讯作者：
Jais, Pierre
DOI：
10.1016/j.jacep.2016.02.009
发表时间：
2016-11-01
期刊：
JACC. Clinical electrophysiology
影响因子：
--
作者：
Gizurarson, Sigfus;Dalvi, Rupin;Chauhan, Vijay S
通讯作者：
Chauhan, Vijay S
DOI：
10.1161/circep.115.002721
发表时间：
2015-06
期刊：
Circulation. Arrhythmia and electrophysiology
影响因子：
--
作者：
Benharash P;Buch E;Frank P;Share M;Tung R;Shivkumar K;Mandapati R
通讯作者：
Mandapati R