Novel Multiscale Frequency Approach to Identify the Pivot Point of the Rotor
Novel Multiscale Frequency Approach to Identify the Pivot Point of the Rotor
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DOI：
10.1115/1.4033148
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发表时间：
2016-06-01
影响因子：
0.9
通讯作者：
Tolkacheva, Elena G.
中科院分区：
文献类型：
--
作者：
Arunachalam, Shivaram Poigai;Annoni, Elizabeth M.;Tolkacheva, Elena G.
背景心房颤动（AF）是最常见的持续性心律失常，是中风、心力衰竭甚至死亡的预后标志物[1]。现在普遍认为转子，即心脏兴奋的稳定电源，可以引起房颤[2]。转子的枢轴点（或核心）被认为是终止患者 AF 的良好消融目标。 CONFIRM 试验在阵发性、持续性和长期 AF 患者中消融这些部位，证实了约 77.8% 的成功率 [3]。目前用于引导导管消融的绘图方法，例如局部激活时间图、复杂分割心房电图平均指数图、主频率（DF）、相位奇异性和波块分析，提供了有关房颤时空组织的信息，然而，由于各种噪声、误导性相位和扭曲这些图的激活时间，它们在准确识别转子枢轴点方面受到许多限制。
BackgroundAtrial fibrillation (AF) is the most common sustained cardiac arrhythmia and is a prognostic marker for stroke, heart failure, and even death [1]. There is now a general consensus that rotors, ie, stable electrical sources of cardiac excitation, can cause AF [2]. The pivot points (or cores) of the rotors are believed to be good ablation targets to terminate AF in patients. About 77.8% success rate was demonstrated by ablation of such sites with the CONFIRM trial in paroxysmal, persistent, and long-standing AF patients [3]. Current mapping methods used for guiding catheter ablation such as local activation time map, complex fractionated atrial electrograms mean index map, dominant frequency (DF), phase singularity, and wave block analysis provide information about the spatiotemporal organization of AF, however, they suffer numerous limitations to accurately identify the rotor pivot points due to various noises, misleading phase, and activation times that distort these maps.