Evaluation of Multiscale Frequency Approach for Visualizing Rotors in Patients with Atrial Fibrillation

Area of Science:

• Cardiology
• Medical Imaging
• Computational Biology

Background:

• Persistent atrial fibrillation (AF) is a common arrhythmia linked to stroke and heart failure.
• Catheter ablation success is limited in persistent AF, particularly when rotors originate outside pulmonary veins.
• Accurate identification of rotor pivot points is crucial for effective ablation therapy.

Purpose of the Study:

• To extend the multiscale frequency (MSF) technique for rotor pivot point identification to 3D intracardiac electrograms (iEGMs).
• To compare the predictive accuracy of the MSF technique against the traditional dominant frequency (DF) approach in human atria.
• To evaluate the potential of MSF for identifying optimal ablation sites in persistent AF.

Main Methods:

• Developed and applied the MSF technique to 3D iEGM data from human atria.
• Compared MSF predictions with traditional DF analysis using Pearson's correlation and earth mover's distance.
• Validated the MSF technique's ability to identify rotor pivot points in simulated and experimental data.

Main Results:

• The MSF technique demonstrated high similarity with DF in some regions but significant differences in others.
• Low similarity regions between MSF and DF indicate potential inconsistencies in the traditional DF approach.
• The MSF technique shows promise for accurately localizing rotor pivot points outside the pulmonary veins.

Conclusions:

• The MSF technique offers a more accurate method for identifying rotor pivot points compared to the traditional DF approach in persistent AF.
• Identifying regions with low MSF-DF similarity could reveal critical ablation targets for improved treatment outcomes.
• This novel approach may enhance the efficacy of catheter ablation for patients with persistent atrial fibrillation.