Sommer Philipp, Castellano Steven, Ahapov Kostiantyn, Jansen Marloes M, Mehta Nishaki K, Kong Melissa H
Med. Fakultät OWL, Clinic for Electrophysiology, Herz- and Diabeteszentrum NRW, Ruhr University Bochum, University Bielefeld, Bad Oeynhausen, Germany.
Cortex Inc, Menlo Park, CA, USA.
J Interv Card Electrophysiol. 2024 Nov 27. doi: 10.1007/s10840-024-01946-0.
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.
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.
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).
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.
心电解图血流（EGF）标测可重建心房电波前传播，有可能揭示房颤（AF）的起源。心电解图血流一致性（EGFC）可测量波前模式的一致性，并可能为心房基质健康状况提供见解。本研究旨在比较房颤（AF）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，房颤患者接受了双极电压和EGF标测的心房标测。在房颤和窦性心律期间，使用16电极格栅导管（双极标测）和64极篮状导管（EGF标测）进行标测。EGFC计算为各个EGF向量的平均模量，反映血流模式的一致性。
纳入10例患者。EGF在房颤期间识别出11个起源，平均起源活动为32±9%。房颤期间11个起源中的8个在窦性心律标测时转变为被动“汇”。与窦性心律相比，房颤期间的EGFC显著降低（0.74±0.14对1.0±0.11 AU，P<0.01），这与EGFC量化心律失常期间更混乱的波前传播一致。未观察到房颤和窦性心律期间高EGFC区域之间的空间相关性。EGFC在不同心律和心房中与双极电压相关（r=0.647，P<0.0001）。
EGF模式随心律变化，房颤时EGFC值较低。EGFC在不同心律和心房中与双极电压相关，表明其有可能作为类似于高密度电压标测的心房肌病标志物，并为心房基质健康状况提供见解。试验注册ClinicalTrials.gov标识符：NCT06260670。
