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Electrographic Flow Mapping Provides Prognosis for AF Ablation Outcomes Across Two Independent Prospective Patient
Kent R Nilsson1,2, Amitesh Anerao2, Melissa H Kong3
1Department of Cardiac Electrophysiology, Piedmont Heart Institute, Athens, GA 30309, USA.
Journal of Clinical Medicine
|February 13, 2025
Summary
Electrographic flow mapping in atrial fibrillation (AF) shows that high consistency and absence of sources predict better outcomes. This method helps identify AF phenotypes for personalized treatment and recurrence prediction.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Imaging
Background:
- Atrial fibrillation (AF) management benefits from understanding wavefront propagation patterns.
- Electrographic flow (EGF) mapping visualizes and quantifies these patterns.
- EGF-identified sources and electrographic flow consistency (EGFC) are key metrics for AF phenotyping.
Purpose of the Study:
- To compare patient phenotypes, treatments, and outcomes between the FLOW-AF trial and the AF-FLOW Global Registry.
- To validate the predictive value of EGF-based AF phenotypes for recurrence.
- To assess the impact of source presence and EGFC on AF recurrence.
Main Methods:
- Comparison of patient data from the FLOW-AF trial and the AF-FLOW Global Registry.
- Analysis of electrographic flow mapping data, including source presence and EGFC.
- Correlation of EGF-based phenotypes with 12-month freedom from AF (FFAF) rates.
Main Results:
- High EGFC (>0.62) was associated with 81% FFAF, versus 46% for low EGFC (≤0.62).
- Biatrial low EGFC correlated with the highest AF recurrence rates.
- Eliminating EGF-identified sources improved FFAF by 30% in PVI-only patients.
Conclusions:
- EGF-based AF phenotypes consistently predict patient outcomes across different cohorts and centers.
- Patients with high EGFC and no post-ablation sources achieve the best outcomes.
- EGF mapping offers valuable insights into AF pathophysiology and can prospectively predict recurrence.
