A single-center trial of electrographic flow mapping and concomitant voltage mapping in sinus rhythm and atrial fibrillation (FLOW EVAL-AF).

IF 2.1 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Interventional Cardiac Electrophysiology Pub Date : 2024-11-27 DOI:10.1007/s10840-024-01946-0

Philipp Sommer, Steven Castellano, Kostiantyn Ahapov, Marloes M Jansen, Nishaki K Mehta, Melissa H Kong

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引用次数: 0

Abstract

Background: Electrographic flow (EGF) mapping reconstructs atrial electrical wavefront propagation, potentially revealing sources of atrial fibrillation (AF). Electrographic flow consistency (EGFC) measures the concurrence of wavefront patterns and may provide insights into atrial substrate health. This study aimed to compare EGF patterns during atrial fibrillation (AF) with sinus rhythm (SR) and explore the correlation between EGFC and regional bipolar voltage.

Methods: In this single-center, prospective study, AF patients underwent mapping of the atria using bipolar voltage and EGF mapping. Mapping was performed during both AF and SR using a 16-electrode grid catheter (bipolar mapping) and a 64-pole basket catheter (EGF mapping). EGFC was computed as the average modulus of individual EGF vectors, reflecting flow pattern consistency.

Results: Ten patients were enrolled. EGF identified 11 sources with a mean source activity of 32 ± 9% during AF. Eight out of eleven sources in AF converted to passive "sinks" when mapped in SR. EGFC was significantly lower during AF compared to SR (0.74 ± 0.14 vs 1.0 ± 0.11 AUs, P < 0.01), consistent with EGFC quantifying the more chaotic wavefront propagation during arrhythmia. No spatial correlation between areas of high EGFC during AF and SR was observed. EGFC correlated with bipolar voltage across rhythms and atria (r = 0.647, P < 0.0001).

Conclusion: EGF patterns varied by rhythm with AF showing lower EGFC values. EGFC correlated with bipolar voltage across rhythms and atria, suggesting its potential as an atrial myopathy marker akin to high-density voltage mapping and offering insights into atrial substrate health. Trial registration ClinicalTrials.gov Identifier: NCT06260670.

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在窦性心律和心房颤动中进行电图血流图和同步电压图的单中心试验（FLOW EVAL-AF）。

背景：电图血流（EGF）绘图可重建心房电波面传播，从而揭示心房颤动（AF）的潜在来源。电图血流一致性（EGFC）测量波前模式的一致性，可帮助了解心房基底健康状况。本研究旨在比较心房颤动（房颤）和窦性心律（SR）期间的 EGF 模式，并探讨 EGFC 与区域双极电压之间的相关性：在这项单中心前瞻性研究中，心房颤动患者接受了使用双极电压和 EGF 映射的心房映射。在房颤和SR期间，使用16电极网格导管（双极映射）和64电极篮导管（EGF映射）进行映射。EGFC 以单个 EGF 向量的平均模量计算，反映血流模式的一致性：结果：10 名患者入选。EGF 确定了 11 个来源，房颤期间平均来源活动度为 32 ± 9%。在 SR 中映射时，房颤时的 11 个源中有 8 个转换为被动 "汇"。与 SR 相比，房颤期间的 EGFC 明显较低（0.74 ± 0.14 vs 1.0 ± 0.11 AUs，P 结论：EGF模式因节律而异，房颤时EGFC值较低。EGFC 与不同节律和心房的双极电压相关，这表明它有可能成为类似于高密度电压图的心房肌病标记物，并提供有关心房基质健康的见解。试验注册 ClinicalTrials.gov Identifier：NCT06260670。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Interventional Cardiac Electrophysiology 医学-心血管系统

CiteScore

4.30

自引率

11.10%

发文量

320

审稿时长

4-8 weeks

期刊介绍： The Journal of Interventional Cardiac Electrophysiology is an international publication devoted to fostering research in and development of interventional techniques and therapies for the management of cardiac arrhythmias. It is designed primarily to present original research studies and scholarly scientific reviews of basic and applied science and clinical research in this field. The Journal will adopt a multidisciplinary approach to link physical, experimental, and clinical sciences as applied to the development of and practice in interventional electrophysiology. The Journal will examine techniques ranging from molecular, chemical and pharmacologic therapies to device and ablation technology. Accordingly, original research in clinical, epidemiologic and basic science arenas will be considered for publication. Applied engineering or physical science studies pertaining to interventional electrophysiology will be encouraged. The Journal is committed to providing comprehensive and detailed treatment of major interventional therapies and innovative techniques in a structured and clinically relevant manner. It is directed at clinical practitioners and investigators in the rapidly growing field of interventional electrophysiology. The editorial staff and board reflect this bias and include noted international experts in this area with a wealth of expertise in basic and clinical investigation. Peer review of all submissions, conflict of interest guidelines and periodic editorial board review of all Journal policies have been established.