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Atrial fibrosis identification with unipolar electrogram eigenvalue distribution analysis in multi-electrode arrays.
- Source :
- Medical & Biological Engineering & Computing; Nov2022, Vol. 60 Issue 11, p3091-3112, 22p, 1 Color Photograph, 6 Diagrams, 7 Charts, 1 Graph
- Publication Year :
- 2022
-
Abstract
- Atrial fibrosis plays a key role in the initiation and progression of atrial fibrillation (AF). Atrial fibrosis is typically identified by a peak-to-peak amplitude of bipolar electrograms (b-EGMs) lower than 0.5 mV, which may be considered as ablation targets. Nevertheless, this approach disregards signal spatiotemporal information and b-EGM sensitivity to catheter orientation. To overcome these limitations, we propose the dominant-to-remaining eigenvalue dominance ratio (EIGDR) of unipolar electrograms (u-EGMs) within neighbor electrode cliques as a waveform dispersion measure, hypothesizing that it is correlated with the presence of fibrosis. A simulated 2D tissue with a fibrosis patch was used for validation. We computed EIGDR maps from both original and time-aligned u-EGMs, denoted as [Formula: see text] and [Formula: see text], respectively, also mapping the gain in eigenvalue concentration obtained by the alignment, [Formula: see text]. The performance of each map in detecting fibrosis was evaluated in scenarios including noise and variable electrode-tissue distance. Best results were achieved by [Formula: see text], reaching 94% detection accuracy, versus the 86% of b-EGMs voltage maps. The proposed strategy was also tested in real u-EGMs from fibrotic and non-fibrotic areas over 3D electroanatomical maps, supporting the ability of the EIGDRs as fibrosis markers, encouraging further studies to confirm their translation to clinical settings. Upper panels: map of [Formula: see text] from 3×3 cliques for Ψ= 0∘ and bipolar voltage map Vb-m, performed assuming a variable electrode-to-tissue distance and noisy u-EGMs (noise level σv = 46.4 μV ). Lower panels: detected fibrotic areas (brown), using the thresholds that maximize detection accuracy of each map. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 01400118
- Volume :
- 60
- Issue :
- 11
- Database :
- Complementary Index
- Journal :
- Medical & Biological Engineering & Computing
- Publication Type :
- Academic Journal
- Accession number :
- 159531215
- Full Text :
- https://doi.org/10.1007/s11517-022-02648-3