Abstract

Atrial Fibrillation (AF) is the most common cardiac rhythm disorder seen in hospitals and in general practice, accounting for up to a third of arrhythmia related hospitalizations. Unfortunately, AF treatment is in practice complicated by the lack of understanding of the fundamental mechanisms underlying the arrhythmia, which makes detection of effective ablation targets particularly difficult. Various approaches to AF mapping have been explored in the hopes of better pinpointing these effective targets, such as Dominant Frequency (DF) analysis, complex fractionated electrograms (CFAE) and unipolar reconstruction (FIRM), but many of these methods have produced conflicting results or require further investigation. Exploration of AF using information theoretic-based approaches may have the potential to provide new insights into the complex system dynamics of AF, whilst also providing the benefit of being less reliant on empirically derived definitions in comparison to alternate mapping approaches. This work provides an overview of information theory and reviews its applications in AF analysis, with particular focus on AF mapping. The works discussed in this review demonstrate how understanding AF from a signal property perspective can provide new insights into the arrhythmic phenomena, which may have valuable clinical implications for AF mapping and ablation in the future.

Highlights

  • Catheter ablation is a potentially curative treatment for atrial fibrillation (AF) that has been gaining interest within the last few decades

  • AF has been a long-standing topic of research, there remains continuing debate regarding the mechanisms underlying the dynamics of the heart rhythm disorder (Schotten et al, 2011)

  • There is some consensus that AF is the result of an interplay between substrate and triggering mechanism, though it is agreed that this interaction is not yet completely understood, nor is the triggering mechanism responsible

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Summary

INTRODUCTION

Catheter ablation is a potentially curative treatment for atrial fibrillation (AF) that has been gaining interest within the last few decades. It uses percutaneously induced catheters to apply focal burns to specific areas of heart muscle in order to cease or modify the AF (Baumert et al, 2016) This method was first popularized following the breakthrough investigation published by Haissaguerre et al (1998), which reported successful termination of up to 90% of paroxysmal AF (PAF) cases using catheter ablation on ectopic triggers located at the pulmonary veins. We begin by introducing the concept of information theory, and follow by discussing the use of information theoretic-based measures of entropy in three common areas of AF research: (i) AF detection, (ii) AF prediction and characterization, and (iii) AF mapping.

What Is Information Theory?
What Is Information and How Can It Be Measured?
SHANNON ENTROPY
APPROXIMATE ENTROPY
SAMPLE ENTROPY
Xn Xnm
MULTISCALE ENTROPY
WAVELET ENTROPY
TRANSFER ENTROPY
Limitations of Entropy
INFORMATION THEORY AND THE INTRACARDIAC ELECTROGRAM
AF Type
CURRENT STUDIES USING INFORMATION THEORETIC APPROACHES IN ATRIAL FIBRILLATION
Entropy for AF Detection
Entropy for AF Prediction and Characteristic Determination
Entropy for AF Mapping
RESEARCH GAPS AND POTENTIAL FUTURE DEVELOPMENTS
CONCLUSION
Findings
AUTHOR CONTRIBUTIONS
Full Text
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