Rodrigo, MiguelWaddell, KianMagee, SarahRogers, Albert J.Alhusseini, MahmoodHernández-Romero, IsmaelCostoya-Sánchez, AlejandroLiberos, AlejandroNarayan, Sanjiv M.2022-06-152022-06-152021-01-061664-042Xhttps://riunet.upv.es/handle/10251/183348[EN] Introduction: Regional differences in activation rates may contribute to the electrical substrates that maintain atrial fibrillation (AF), and estimating them non-invasively may help guide ablation or select anti-arrhythmic medications. We tested whether non-invasive assessment of regional AF rate accurately represents intracardiac recordings. Methods: In 47 patients with AF (27 persistent, age 63 +/- 13 years) we performed 57-lead non-invasive Electrocardiographic Imaging (ECGI) in AF, simultaneously with 64-pole intracardiac signals of both atria. ECGI was reconstructed by Tikhonov regularization. We constructed personalized 3D AF rate distribution maps by Dominant Frequency (DF) analysis from intracardiac and non-invasive recordings. Results: Raw intracardiac and non-invasive DF differed substantially, by 0.54 Hz [0.13 - 1.37] across bi-atrial regions (R-2 = 0.11). Filtering by high spectral organization reduced this difference to 0.10 Hz (cycle length difference of 1 - 11 ms) [0.03 - 0.42] for patient-level comparisons (R-2 = 0.62), and 0.19 Hz [0.03 - 0.59] and 0.20 Hz [0.04 - 0.61] for median and highest DF, respectively. Non-invasive and highest DF predicted acute ablation success (p = 0.04). Conclusion: Non-invasive estimation of atrial activation rates is feasible and, when filtered by high spectral organization, provide a moderate estimate of intracardiac recording rates in AF. Non-invasive technology could be an effective tool to identify patients who may respond to AF ablation for personalized therapy.Reconocimiento (by)Atrial fibrillationDriverDominant frequencyNon-invasive mappingElectrocardiographic imagingBasket mappingTECNOLOGIA ELECTRONICAArtículo10.3389/fphys.2020.611266Abierto33584334PMC7873897