4 years ago

Absence of Rotational Activity Detected Using Two-Dimensional Phase Mapping In Corresponding Three-Dimensional Phase Maps In Human Persistent Atrial Fibrillation

Current phase mapping systems for atrial fibrillation(AF) create two-dimensional(2D) maps. This process may affect the accurate detection of rotors. We developed a three-dimensional(3D) phase mapping technique that utilizes the 3D locations of basket electrodes to project phase onto patient-specific left atrial(LA) 3D surface anatomy. Objectives We sought to determine whether rotors detected in 2D phase maps were present at corresponding time segments and anatomical locations on 3D phase maps. Methods One-minute LA AF recordings were obtained in 14 patients using the basket catheter and analyzed off-line. Using the same phase values, 2D and 3D phase maps were created. Analysis involved determining the dominant propagation patterns in 2D phase maps and evaluating the presence of rotors detected in 2D phase maps in corresponding 3D phase maps. Results Using 2D phase mapping, the dominant propagation pattern was single wavefront(36.6%) followed by focal activation(34.0%), disorganized activity(23.7%), rotors(3.3%) and multiple wavefronts(2.4%). 10 transient rotors were observed in 9/14(64%) patients. Mean rotor duration was 1.1±0.7s. None of the 10 rotors observed in 2D phase maps were seen in corresponding time segments and anatomical locations in 3D phase maps; 4/10 corresponded with single wavefronts in 3D phase maps, 2/10 with two simultaneous wavefronts, 1/10 with disorganized activity and in 3/10 there was no coverage by the basket catheter at the corresponding 3D anatomical location. Conclusions Rotors detected in 2D phase maps were not observed in corresponding 3D phase maps. These findings may have implications for current systems which use 2D phase mapping.

Publisher URL: www.sciencedirect.com/science

DOI: S1547527117310895

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