An interactive platform to guide catheter ablation in human persistent atrial fibrillation using dominant frequency,...

Area of Science:

• Cardiology
• Medical Technology
• Biomedical Engineering

Background:

• Optimal ablation targets for persistent atrial fibrillation (persAF) remain debated.
• High dominant frequency (HDF) regions and rotors are implicated in persAF maintenance.
• Current systems lack integrated mapping of both HDF and phase for ablation guidance.

Purpose of the Study:

• To describe an integrated 3D software platform for mapping HDF and phase from atrial electrograms (AEGs).
• To evaluate the platform's utility in guiding catheter ablation for persAF.
• To facilitate a better understanding of persAF mechanisms through spatiotemporal analysis.

Main Methods:

• Analysis of 30s non-contact AEGs from 10 persAF patients.
• Utilized Fast Fourier Transform for HDF identification and Hilbert transform for instantaneous phase calculation.
• Tracked spatiotemporal movement of HDF areas using centers of gravity (CGs).

Main Results:

• The integrated software platform was successfully used to guide catheter ablation in 10 persAF patients.
• Mean processing time was 10.4 ± 1.5 minutes, significantly shorter than standard electrophysiology procedures.
• The system enabled comprehensive spatiotemporal analysis of AEGs.

Conclusions:

• A novel software platform for persAF ablation guidance has been developed and clinically implemented.
• The platform integrates HDF and phase mapping for comprehensive AEG analysis.
• Its modular design supports further research into AF mechanisms and ablation strategies.