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High-Resolution Endocardial and Epicardial Optical Mapping in a Sheep Model of Stretch-Induced Atrial Fibrillation
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Comparing phase and electrographic flow mapping for persistent atrial fibrillation.

M Swerdlow1, M Tamboli1, M I Alhusseini1

  • 1Cardiovascular Medicine, Stanford University, Stanford, California.

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|March 19, 2019
PubMed
Summary
This summary is machine-generated.

Electrographic flow mapping (EGF) and phase mapping effectively identify atrial fibrillation (AF) sources. EGF detected more localized sources globally than phase mapping, offering complementary insights for AF ablation strategies.

Keywords:
atrial fibrillationelectrographic flowelectrophysiologymappingphase

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Imaging

Background:

  • Atrial fibrillation (AF) mapping methods are evolving, but their sensitivity in identifying localized AF sources remains unclear.
  • Persistent AF ablation success relies on accurate source identification.

Purpose of the Study:

  • To compare the sensitivity and effectiveness of electrographic flow mapping (EGF) and phase mapping in identifying localized atrial fibrillation (AF) sources.
  • To assess if these mapping methods can detect AF termination sites.

Main Methods:

  • A multicenter registry of 53 patients with persistent AF undergoing ablation was analyzed.
  • Simultaneous electrograms from a 64-pole basket catheter were used for both EGF and phase mapping.
  • The ability of each method to detect localized sources at AF termination sites and global mapping patterns was evaluated.

Main Results:

  • Both EGF and phase mapping identified localized sources at AF termination sites in 81% and 83% of patients, respectively.
  • EGF identified significantly more localized sources globally compared to phase mapping (5.3 vs 1.8, P < 0.001).
  • EGF revealed a higher prevalence of focal activation patterns (49%) compared to rotational patterns (2%).

Conclusions:

  • Electrographic flow mapping (EGF) is a novel vectorial-based method that effectively detects AF termination sites.
  • EGF results agree with and complement traditional phase mapping methods.
  • These findings support the utility of EGF as a valuable tool in AF mapping and ablation guidance.