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The spiral wave frequency effect in atrial fibrillation
Donald S Rubenstein1, Mason A Rubenstein2, James R Cummins3
1Department of Medicine, Prisma Health Upstate Campus, Greenville, South Carolina.
Biophysical Journal
|February 11, 2024
Summary
Spiral rotors in atrial fibrillation create unique frequency changes not explained by classical Doppler effects. These findings challenge current mapping and ablation strategies for cardiac arrhythmias.
Area of Science:
- Cardiovascular Electrophysiology
- Nonlinear Dynamics
Background:
- Cardiac rotors during atrial fibrillation (AF) generate spiral wavefronts (WFs).
- Observed WF frequency changes during AF are inconsistent with classical Doppler effect (CDE) predictions.
- Clinical studies report unique rotor behaviors: side-dependent frequencies, extra WF strikes, and reversed strike sequences.
Purpose of the Study:
- To investigate the diametrical properties of spiral wavefront sources during AF.
- To develop mathematical models explaining observed WF phenomena.
- To re-evaluate current mapping and ablation strategies for AF.
Main Methods:
- Development of a linear ray model to analyze diametrical phenomena.
- Mathematical modeling of Archimedean spirals and diffusion equation-generated spirals.
- Comparison of model predictions with clinical observations.
Main Results:
- Models predict a diametrical property not captured by CDE.
- Spiral rotors exhibit distinct "strong" and "weak" sides relative to their path.
- Higher and lower frequencies are generated on opposite sides of the rotor migration path, unlike CDE.
Conclusions:
- Spiral rotor dynamics present a diametrical property distinct from CDE.
- Findings necessitate a reconsideration of AF mapping and ablation techniques.
- The study's principles apply to other systems exhibiting rotating spiral waves.
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