Electrographic flow mapping for atrial fibrillation: theoretical basis and preliminary observations

Area of Science:

• Electrophysiology
• Medical Device Technology
• Computational Biology

Background:

• Ablation strategies for persistent atrial fibrillation (AF) with recurrence after pulmonary vein isolation (PVI) require advanced mapping.
• Current mapping technologies face limitations in localizing AF triggers and drivers.
• Improved PVI durability necessitates better methods for identifying extra-pulmonary vein sources.

Purpose of the Study:

• To provide an in-depth explanation of the technical and mathematical foundations of Electrographic Flow (EGF) mapping.
• To demonstrate the clinical applications of EGF mapping data and analyses.
• To introduce a novel mapping method for identifying AF sources.

Main Methods:

• Utilizing a 64-electrode basket catheter to record unipolar electrograms (EGMs).
• Processing EGMs with an algorithm based on optical flow and fluid dynamics principles.
• Visualizing electrographic flow to reconstruct wavefront propagation and identify AF sources.

Main Results:

• EGF mapping enables full spatiotemporal reconstruction of organized wavefront propagation during AF.
• The method visualizes electrographic flow, highlighting locations of high prevalence AF source activity.
• AF sources identified by EGF mapping are independent of specific signal generation mechanisms.

Conclusions:

• EGF mapping is a novel technique with the potential to improve the understanding and treatment of persistent AF.
• The method offers a new way to visualize and localize AF drivers, addressing limitations of current technologies.
• Further clinical application and validation of EGF mapping are warranted for persistent AF management.