TY - JOUR
T1 - Searching for "order" in atrial fibrillation using electrogram morphology recurrence plots
AU - Gordon, David
AU - Goldberger, Jeffrey J.
AU - Arora, Rishi
AU - Aistrup, Gary L.
AU - Ng, Jason
N1 - Funding Information:
This study was funded in part by the American Heart Association ( 12GRNT12070241 ) and the NIH National Heart Lung and Blood Institute ( R01 HL093490 ). The study sponsors had no involvement in the study design, in the collection, analysis and interpretation of data; in the writing of the manuscript; and in the decision to submit the manuscript for publication.
Funding Information:
Drs. Gordon, Goldberger, Arora and Ng were supported by a grant from the American Heart Association (12GRNT12070241).
Publisher Copyright:
© 2015 Elsevier Ltd.
PY - 2015/10/1
Y1 - 2015/10/1
N2 - Background: Bipolar electrograms recorded during atrial fibrillation (AF) can have an appearance of chaotic/random behavior. The aim of this study was to use a novel electrogram morphology recurrence (EMR) analysis to quantify the level of order in the morphology patterns in AF. Methods: Rapid atrial pacing was performed in seven dogs at 600. bpm for 3 weeks leading to sustained AF. Open chest high density electrical recordings were made in multiple atrial sites. EMR plots of bipolar electrograms at each site were created by cross-correlating morphologies of each detected activations with morphologies of every other activation. The following features of the EMR plots were quantified: recurrence rate (RR), determinism (DET), laminarity (LAM), average diagonal line length (L), trapping time (TT), divergence (DIV), and Shannon's entropy (ENTR). For each recording site, these measures were calculated for the normal sequence of morphologies and also after random shuffling of the electrogram orders. Results: Electrograms recordings from a total of 3961 sites had average cycle lengths of 104±22. ms resulting in an average of 100±19 activations detected per 10-s recording and an average RR of 0.38±0.28 (range 0.02-1.00). Shuffling the order of the activation morphologies resulted in significant decreases in DET, LAM, L, TT, and ENTR and significant increases in DIV. Conclusions: EMR plots of AF electrograms show varying rates of recurrence with patterns that suggest an underlying deterministic structure to the activation sequences. A better understanding of AF dynamics could lead to improved methods in mapping and treating AF.
AB - Background: Bipolar electrograms recorded during atrial fibrillation (AF) can have an appearance of chaotic/random behavior. The aim of this study was to use a novel electrogram morphology recurrence (EMR) analysis to quantify the level of order in the morphology patterns in AF. Methods: Rapid atrial pacing was performed in seven dogs at 600. bpm for 3 weeks leading to sustained AF. Open chest high density electrical recordings were made in multiple atrial sites. EMR plots of bipolar electrograms at each site were created by cross-correlating morphologies of each detected activations with morphologies of every other activation. The following features of the EMR plots were quantified: recurrence rate (RR), determinism (DET), laminarity (LAM), average diagonal line length (L), trapping time (TT), divergence (DIV), and Shannon's entropy (ENTR). For each recording site, these measures were calculated for the normal sequence of morphologies and also after random shuffling of the electrogram orders. Results: Electrograms recordings from a total of 3961 sites had average cycle lengths of 104±22. ms resulting in an average of 100±19 activations detected per 10-s recording and an average RR of 0.38±0.28 (range 0.02-1.00). Shuffling the order of the activation morphologies resulted in significant decreases in DET, LAM, L, TT, and ENTR and significant increases in DIV. Conclusions: EMR plots of AF electrograms show varying rates of recurrence with patterns that suggest an underlying deterministic structure to the activation sequences. A better understanding of AF dynamics could lead to improved methods in mapping and treating AF.
KW - Atrial fibrillation
KW - Dynamics
KW - Electrograms
KW - Mapping
KW - Non-linear analysis
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U2 - 10.1016/j.compbiomed.2015.07.018
DO - 10.1016/j.compbiomed.2015.07.018
M3 - Article
C2 - 26255963
AN - SCOPUS:84942373369
VL - 65
SP - 220
EP - 228
JO - Computers in Biology and Medicine
JF - Computers in Biology and Medicine
SN - 0010-4825
ER -