Phase Variance Analysis for Identifying Heterogeneous Conduction Regions in Persistent Atrial Fibrillation: Impact of...

Area of Science:

• Electrophysiology
• Cardiac Arrhythmia Research
• Medical Imaging Analysis

Background:

• Phase variance analysis quantifies spatial heterogeneity in local activation.
• Its reliability is influenced by recording duration, particularly in atrial fibrillation (AF).
• Understanding this influence is crucial for accurate characterization of complex conduction patterns.

Purpose of the Study:

• To determine how recording duration affects the accuracy and reproducibility of phase variance analysis.
• To assess the reliability of identifying heterogeneous conduction regions in persistent AF.
• To establish optimal recording durations for reliable analysis.

Main Methods:

• Intracardiac electrograms from 16 left atrial sites in 5 persistent AF patients were analyzed.
• Phase variance maps were generated from varying recording durations (0.01-25s).
• Accuracy was measured by structural similarity index (SSIM), and reproducibility by pixel-wise standard deviations.

Main Results:

• Longer recording durations correlated with higher SSIM values and lower standard deviations.
• Recordings ≥10s yielded SSIM > 0.95 and standard deviations < 0.015.
• This indicates accurate and stable estimation of complex conduction patterns with sufficient duration.

Conclusions:

• Adequate recording duration is essential for accurate and reproducible phase variance analysis in AF.
• The method reliably estimates heterogeneous conduction, even in complex persistent AF.
• This supports improved ablation target selection and patient outcomes.