Electrographic Flow mapping for atrial fibrillation: theoretical basis and preliminary observations

Ablation strategies remain poorly defined for persistent atrial fibrillation (AF) patients with recurrence despite intact pulmonary vein isolation (PVI). As the ability to perform durable PVI improves, the need for advanced mapping to identify extra-PV sources of AF becomes increasingly evident. Multiple mapping technologies attempt to localize these self-sustained triggers and/or drivers responsible for initiating and/or maintaining AF; however, current approaches suffer from technical limitations. Electrographic flow (EGF) mapping is a novel mapping method based on well-established principles of optical flow and fluid dynamics. It enables the full spatiotemporal reconstruction of organized wavefront propagation within the otherwise chaotic and disorganized electrical conduction of AF. Given the novelty of EGF mapping and relative unfamiliarity of most clinical electrophysiologists with the mathematical principles powering the EGF algorithm, this paper provides an in-depth explanation of the technical/mathematical foundations of EGF mapping and demonstrates clinical applications of EGF mapping data and analyses.

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First-in-man demonstration of 18-month spatiotemporal stability of active atrial fibrillation source detected by Electrographic Flow mapping in persistent atrial fibrillation

The aim of this first-in-man Case report is to demonstrate the spatiotemporal stability and long-term reproducibility of a putative AF source in a patient suffering from long-standing persistent AF associated with hypertrophic cardiomyopathy, by comparing EGF maps recorded 18 months apart.

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Comparing phase and electrographic flow mapping for persistent atrial fibrillation

An increasing number of methods are being used to map atrial fibrillation (AF), yet the sensitivity of identifying potential localized AF sources of these novel methods are unclear. Here, we report a comparison of two approaches to map AF based upon (1) electrographic flow mapping and (2) phase mapping in a multicenter registry of patients in whom ablation terminated persistent AF.

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Identification of active atrial fibrillation sources and their discrimination from passive rotors using electrographical flow mapping

The optimal ablation approach for the treatment of persistent atrial fibrillation (AF) is still under debate; however, the identification and elimination of AF sources is thought to play a key role. Currently available technologies for the identification of AF sources are not able to differentiate between active rotors or focal impulse (FI) and passive circular turbulences as generated by the interaction of a wave front with a functional obstacle such as fibrotic tissue.

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