Prospective cross-sectional study using Poisson renewal theory to study phase singularity formation and destruction...

Area of Science:

• Cardiology
• Electrophysiology
• Medical Physics

Background:

• Rotors, or unstable reentrant circuits, are implicated in maintaining atrial fibrillation (AF).
• Rotor formation (λf) and destruction (λd) rates can be quantified using in vivo electrophysiologic data.
• The relationship between these rotor dynamics and AF clinical phenotype markers is not well understood.

Purpose of the Study:

• To determine the association of λf and λd with clinical, electrical, and structural markers of AF phenotype.
• To explore the feasibility of noninvasively assessing λf and λd using surface ECG characteristics and machine learning.

Main Methods:

• The RENEWAL-AF study is a prospective, multicenter trial involving adult AF patients undergoing catheter ablation.
• Intraprocedural mapping will record unipolar electrograms to calculate λf and λd.
• Clinical, electrical, and structural markers will be assessed using preablation transthoracic echocardiography and cardiac magnetic resonance imaging.

Main Results:

• Results are not applicable for this pilot study phase.

Conclusions:

• This pilot study will offer insights into the correlation between rotor dynamics (λf/λd) and AF phenotype markers.
• Findings will lay the groundwork for developing noninvasive methods to assess rotor dynamics using surface ECGs.
• This could potentially broaden the clinical utility of λf and λd in managing atrial fibrillation.