Use of Atrial Fibrillation Organization to Evaluate the Efficacy of Guided Ablation

Abstract

Catheter ablation is a widely-used therapy to treat atrial fibrillation (AF), but the identification of ablation targets remain challenging in persistent AF (PersAF). This work aims to study the anatomical relationship between rotors and areas of low-voltage, in addition to evaluate the outcomes of PersAF ablation guided by rotors maps in combination with pulmonary vein isolation, through frequency analysis of the electrograms (EGMs).Eight patients with PersAF and no previous ablation procedure were included in this study. Ablation procedures were guided by Carto®3 voltage maps and CardioInsight™ rotors maps. The location of rotors was qualitatively compared with low-voltage areas (<0.5 mV). In addition, frequency analysis was carried out with five bipolar EGMs, recorded by using a decapolar catheter located in the coronary sinus. Spectral analysis was performed using the Welch method. The highest peak in the spectrum was defined as the dominant frequency (DF). To measure the periodicity and organization of the signals, the regularity (IR) and organization (IO) indexes were implemented.Our results showed that rotors location largely corresponded to low-voltage zones (85.7%). In addition, although only one patient restored sinus rhythm after ablation and the remaining patients needed cardioversion, an improvement in DF, RI and OI was observed in 75% of cases.