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Título : Atrial fibrosis identification with unipolar electrogram eigenvalue distribution analysis in multi‑electrode arrays
Autor: Riccio, Jennifer SCOPUSID
Alcaine, Alejandro SCOPUSID
Rocher, Sara SCOPUSID
Martinez-Mateu, Laura SCOPUSID
Laguna, Pablo ORCID RESEARCHERID
Martinez, Juan Pablo ORCID RESEARCHERID
Laguna, Pablo ORCID RESEARCHERID
Saiz, Javier ORCID RESEARCHERID SCOPUSID
Guillem, Maria S ORCID RESEARCHERID
Invers‑Rubio, Eric ORCID
Palabras clave : Atrial fibrosis; Atrial fibrillation (AF); Bipolar electrograms (b-EGMs); Eigenvalue dominance ratio (EIGDR); Unipolar electrograms (u-EGMs)
Fecha de publicación: 13-sep-2022
Editorial : Springer
Resumen : Atrial fibrosis plays a key role in the initiation and progression of atrial fibrillation (AF). Atrial fibrosis is typically identified by a peak-to-peak amplitude of bipolar electrograms (b-EGMs) lower than 0.5 mV, which may be considered as ablation targets. Nevertheless, this approach disregards signal spatiotemporal information and b-EGM sensitivity to catheter orientation. To overcome these limitations, we propose the dominant-to-remaining eigenvalue dominance ratio (EIGDR) of unipolar electrograms (u-EGMs) within neighbor electrode cliques as a waveform dispersion measure, hypothesizing that it is correlated with the presence of fibrosis. A simulated 2D tissue with a fibrosis patch was used for validation. We computed EIGDR maps from both original and time-aligned u-EGMs, denoted as R and RA , respectively, also mapping the gain in eigenvalue concentration obtained by the alignment, ΔRA . The performance of each map in detecting fibrosis was evaluated in scenarios including noise and variable electrode-tissue distance. Best results were achieved by RA , reaching 94% detection accuracy, versus the 86% of b-EGMs voltage maps. The proposed strategy was also tested in real u-EGMs from fibrotic and non-fibrotic areas over 3D electroanatomical maps, supporting the ability of the EIGDRs as fibrosis markers, encouraging further studies to confirm their translation to clinical settings
URI : https://repositorio.usj.es/handle/123456789/888
ISSN : 3091–3112
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