Transient Rotor Activity During Prolonged 3-Dimensional Phase Mapping in Human Persistent Atrial Fibrillation

Area of Science:

• Electrophysiology
• Cardiac Mapping
• Atrial Fibrillation Research

Background:

• Current 2D systems limit phase mapping of atrial fibrillation (AF).
• A novel 3D phase mapping system was developed using basket catheter data and 3D geometry.
• This system interpolates phase data to create a 3D representation of electrical progression.

Purpose of the Study:

• To validate a new 3D phase mapping system for persistent AF.
• To determine the distribution of dominant propagation patterns in persistent AF.
• To compare 3D phase mapping with traditional 3D activation mapping.

Main Methods:

• Utilized a Constellation basket catheter for 6-minute AF recordings in 14 patients.
• Validated phase analysis by comparing beat-to-beat AF cycle length with activation timing.
• Compared 3D phase mapping propagation patterns with 3D activation mapping in 1-minute segments.

Main Results:

• Strong agreement (R²=0.91) between phase inversion and activation timing for AF cycle length.
• No significant differences in propagation pattern classification between 3D phase and 3D activation mapping.
• Single wavefronts (50.2%) were the most common pattern; 34 transient rotors were observed in 9 patients.

Conclusions:

• The 3D phase mapping system accurately represents AF propagation patterns.
• Transient rotors were observed in 64% of patients, reforming in the same location in 44%.
• Basket catheter electrode density may influence rotor detection.