Atrial fibrillation (AF) is a prevalent cardiac arrhythmia, yet understanding its
causes and finding effective treatments remains a challenge. To address this, researchers
are developing innovative approaches based on the identification and analysis
of focal sources, which have been recognised as important in AF initiation.
Non-invasive techniques, such as body surface potential mapping (BSPM) and electrocardiographic
imaging (ECGI), have emerged as valuable tools for studying AF
mechanisms. ...
Atrial fibrillation (AF) is a prevalent cardiac arrhythmia, yet understanding its
causes and finding effective treatments remains a challenge. To address this, researchers
are developing innovative approaches based on the identification and analysis
of focal sources, which have been recognised as important in AF initiation.
Non-invasive techniques, such as body surface potential mapping (BSPM) and electrocardiographic
imaging (ECGI), have emerged as valuable tools for studying AF
mechanisms. However, analyzing the data obtained from these techniques is currently
impractical, and there is a lack of a standardized reference system available
for comparing atrial regions and patients. The integration of ECGI with flattening
algorithms shows promise as an experimental tool that converts complex 3D atrial
geometry into a 2D representation, enabling localized and quantitative analysis of
cardiac electrical activity. In this context, the objective of this study is to combine
these methodologies and establish a pipeline for constructing a common reference
system that facilitates quantitative and localized analysis of focal sources in the left
atria (LA).
To do so, this research employed ECGI data obtained from a cohort of nine patients
who underwent ablation procedures provided by Universitat de València, along
with a flattening algorithm developed at Universitat Pompeu Fabra. Preprocessing
of the data involves optimizing geometries and providing inputs for the flattening
algorithm. Moreover, a new region division is introduced to enable a more localized
and specific analysis of the pulmonary veins (PV) and left atrial appendage (LAA).
A statistical analysis is conducted, quantifying the total number of focal sources and
foci density in different regions and investigating the differences in patient outcomes
between termination and non-termination cases. The results of the study indicate
differences between patients and groups as observed through the regional analysis.
However, due to the limited number of patients involved, it is not yet possible to
draw definitive clinical conclusions.
Overall, the study provides a novel approach to quantitatively and locally analyze
focal sources in the LA, and offers to advance our understanding of AF initiation
mechanisms and provide valuable insights in ablation therapy guidance.
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