Impact of number of co-existing rotors and inter-electrode distance on accuracy of rotor localization

Konstantinos N. Aronis, Hiroshi Ashikaga

Research output: Contribution to journalArticle

Abstract

Background: Conflicting evidence exists on the efficacy of focal impulse and rotor modulation on atrial fibrillation ablation. A potential explanation is inaccurate rotor localization from multiple rotors coexistence and a relatively large (9-11. mm) inter-electrode distance (IED) of the multi-electrode basket catheter. Methods and results: We studied a numerical model of cardiac action potential to reproduce one through seven rotors in a two-dimensional lattice. We estimated rotor location using phase singularity, Shannon entropy and dominant frequency. We then spatially downsampled the time series to create IEDs of 2-30. mm. The error of rotor localization was measured with reference to the dynamics of phase singularity at the original spatial resolution (IED = 1. mm). IED has a significant impact on the error using all the methods. When only one rotor is present, the error increases exponentially as a function of IED. At the clinical IED of 10. mm, the error is 3.8. mm (phase singularity), 3.7. mm (dominant frequency), and 11.8. mm (Shannon entropy). When there are more than one rotors, the error of rotor localization increases 10-fold. The error based on the phase singularity method at the clinical IED of 10. mm ranges from 30.0. mm (two rotors) to 96.1. mm (five rotors). Conclusions: The magnitude of error of rotor localization using a clinically available basket catheter, in the presence of multiple rotors might be high enough to impact the accuracy of targeting during AF ablation. Improvement of catheter design and development of high-density mapping catheters may improve clinical outcomes of FIRM-guided AF ablation.

Original languageEnglish (US)
JournalJournal of Electrocardiology
DOIs
StateAccepted/In press - 2017

Keywords

  • Atrial fibrillation
  • Computational model
  • Mapping
  • Rotor
  • Spiral wave

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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