Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 243.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 243.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Warning: imagejpeg(C:\Inetpub\vhosts\kidney.de\httpdocs\phplern\25729463
.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Card+Electrophysiol+Clin
2015 ; 7
(1
): 59-69
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Frontiers in Non-invasive Cardiac Mapping: Rotors in Atrial Fibrillation-Body
Surface Frequency-Phase Mapping
#MMPMID25729463
Atienza F
; Climent AM
; Guillem MS
; Berenfeld O
Card Electrophysiol Clin
2015[Mar]; 7
(1
): 59-69
PMID25729463
show ga
Experimental and clinical data demonstrate that atrial fibrillation (AF)
maintenance in animals and groups of patients depends on localized reentrant
sources localized primarily to the pulmonary veins (PVs) and the left atrium(LA)
posterior wall in paroxysmal AF but elsewhere, including the right atrium (RA),
in persistent AF. Moreover, AF can be eliminated by directly ablating AF-driving
sources or "rotors," that exhibit high-frequency, periodic activity. The RADAR-AF
randomized trial demonstrated that an ablation procedure based on a more
target-specific strategy aimed at eliminating high frequency sites responsible
for AF maintenance is as efficacious as and safer than empirically isolating all
the PVs. In contrast to the standard ECG, global atrial noninvasive frequency
analysis allows non-invasive identification of high-frequency sources before the
arrival at the electrophysiology laboratory for ablation. Body surface potential
map (BSPM) replicates the endocardial distribution of DFs with localization of
the highest DF (HDF) and can identify small areas containing the high-frequency
sources. Overall, BSPM had a sensitivity of 75% and specificity of 100% for
capturing intracardiac EGMs as having LARA DF gradient. However, raw BSPM data
analysis of AF patterns of activity showed incomplete and instable reentrant
patterns of activation. Thus, we developed an analysis approach whereby a narrow
band-pass filtering allowed selecting the electrical activity projected on the
torso at the HDF, which stabilized the projection of rotors that potentially
drive AF on the surface. Consequently, driving reentrant patterns ("rotors") with
spatiotemporal stability during >70% of the AF time could be observed
noninvasibly after HDF-filtering. Moreover, computer simulations found that the
combination of BSPM phase mapping with DF analysis enabled the discrimination of
true rotational patterns even during the most complex AF. Altogether, these
studies show that the combination of DF analysis with phase maps of HDF-filtered
surface ECG recordings allows noninvasive localization of atrial reentries during
AF and further a physiologically-based rationale for personalized diagnosis and
treatment of patients with AF.
free
free
free
