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Tracking rotors with minimal electrodes: modulation index-based strategy.

Krishnanand Balasundaram¹, Karthikeyan Umapathy¹, Joyce Jeyaratnam¹

¹From the Department of Electrical and Computer Engineering, Ryerson University, Toronto, Ontario, Canada (K.B., K.U., J.J., A.N.); Department of Cardiology, THFCFM Laboratory, Toronto, Ontario, Canada (S.M., T.F., K.N., J.A., K.N.); Department of Cardiology, Toronto General Hospital, Toronto, Ontario, Canada (R.J.C.); and LIRYC Electrophysiology and Heart Modelling Institute, Pessac, France (E.V.); and Laboratory IMB, University of Bordeaux, Talence, France (E.V.).

Circulation. Arrhythmia and Electrophysiology

|March 6, 2015

Summary

This summary is machine-generated.

A new method accurately detects cardiac rotors using unipolar electrograms, enabling potential therapeutic interventions for fibrillation with fewer electrodes. This approach offers a higher detection rate than bipolar methods.

Keywords:

catheter ablation entropy modulation index rotors ventricular fibrillation

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Area of Science:

Cardiovascular Electrophysiology
Medical Signal Processing

Background:

Cardiac fibrillation is characterized by high-frequency periodic sources.
Current detection methods (phase mapping) require extensive electrode arrays and real-time capabilities.
A method is needed to identify electrogram morphologies near rotors using limited electrodes for therapeutic modulation.

Purpose of the Study:

To devise a method for identifying electrogram morphologies that colocalize to cardiac rotors.
To enable rotor detection using a minimal number of electrograms for practical therapeutic applications.

Main Methods:

Analyzed multichannel ventricular fibrillation electrogram data from human hearts (Langendorff and intraoperative).
Identified rotor locations using phase maps from 112 electrograms.
Quantified and discriminated signal morphologies around rotor and nonrotor locations.
Extracted features from unipolar electrogram patterns, including a novel modulation index.

Main Results:

The modulation index feature achieved 86% accuracy in separating rotor from nonrotor locations using as few as 1 sample point.
Unipolar electrogram patterns corroborated well with rotor spatial locations.
Bipolar electrogram analysis showed 62.5% of rotors occurred where continuous activity was present.

Conclusions:

Unipolar electrogram modulation index-based detection of rotors is feasible with few electrodes.
This method demonstrates a higher detection rate compared to bipolar approaches.
The strategy is suitable for non-array-based single mapping catheter detection of rotors.