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Characterization of human persistent atrial fibrillation electrograms using recurrence quantification analysis.

Tiago P Almeida1, Fernando S Schlindwein2, João Salinet3

  • 1Aeronautics Institute of Technology, ITA, São José dos Campos 12228-900, Brazil.

Chaos (Woodbury, N.Y.)
|September 6, 2018
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Summary
This summary is machine-generated.

Recurrence quantification analysis reveals complex dynamics in atrial fibrillation (AF) electrograms. This nonlinear approach helps differentiate normal from fractionated signals, offering new insights into persistent AF mechanisms.

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Area of Science:

  • Cardiology
  • Nonlinear Dynamics
  • Biomedical Engineering

Background:

  • Atrial fibrillation (AF) is a complex arrhythmia with intricate activation patterns.
  • Fractionated atrial electrograms (AEGs) are potential targets for radiofrequency ablation.
  • Current ablation strategies for persistent AF (persAF) have suboptimal outcomes due to complex spatiotemporal dynamics.

Purpose of the Study:

  • To characterize atrial tissue activation dynamics during persAF using recurrence plots (RPs) and recurrence quantification analysis (RQA).
  • To evaluate the effectiveness of RQA in discriminating normal versus fractionated AEGs.
  • To explore the nonlinear dynamics underlying persAF.

Main Methods:

  • Collected 797 bipolar AEGs from 18 persAF patients undergoing pulmonary vein isolation (PVI).
  • Classified AEGs as normal or fractionated using CARTO criteria.
  • Applied RPs and seven RQA variables (recurrence rate, determinism, etc.) to analyze AEG phase space dynamics.

Main Results:

  • RQA variables were significantly affected by PVI.
  • RQA variables effectively discriminated between normal and fractionated AEGs.
  • Fractionated AEGs exhibited deterministic behavior, suggesting potential chaotic dynamics.

Conclusions:

  • RQA provides a valuable nonlinear perspective on persAF spatiotemporal dynamics.
  • RQA can differentiate normal and fractionated AEGs, aiding in understanding arrhythmogenic mechanisms.
  • The presence of deterministic structures in fractionated AEGs may indicate unstable periodic orbits in persAF.