HRX 2024 AbstracX Library-Atrail Extent Comparison of Spatiotemporal Electrogram Dispersion

Atrail Extent Comparison of Spatiotemporal Electrogram Dispersion

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The study conducted by Daniel Guerrero and colleagues focuses on the comparison of spatiotemporal electrogram dispersion and low-voltage areas in patients with persistent atrial fibrillation (AF). Spatiotemporal dispersion, characterized through a mapping approach, is considered a unique fingerprint of the AF substrate in each patient. The research explores how this dispersion correlates with other electrogram-based metrics like low-voltage areas, which are commonly used to identify AF targets for ablation procedures.<br /><br />The study highlights a novel, artificial intelligence-guided spatiotemporal dispersion ablation strategy. Findings from the Ev-AIFib trial conducted by Seitz J and colleagues, published in Heart Rhythm in 2024, are incorporated into the research, showcasing the distinct characteristics of dispersion areas in persistent AF patients. Statistical analysis includes heat maps that demonstrate that all pairwise distances within these areas are far from zero, confirming the uniqueness of the dispersion patterns.<br /><br />In a cohort of 37 patients with persistent AF, comprehensive mapping techniques were used to examine the dispersion and voltage characteristics. The results showed that all patients had dispersion in the left atrium, with a median surface area of 233 cm². Additionally, 51% of the patients presented with low-voltage areas (LV0.2), indicating fibrotic tissue. Interestingly, the spatial extent of low-voltage and spatiotemporal dispersion areas showed limited overlap, suggesting that the dispersed regions were significantly smaller than the low-voltage areas (p < 0.001).<br /><br />The findings underscore the importance of understanding the spatial relationship between dispersion and low-voltage areas, as it can provide operators with insights into targeting specific regions of the AF substrate during ablation procedures. The study aims to enhance precision in AF treatment and pave the way for more personalized therapeutic strategies.

Keywords

spatiotemporal dispersion

low-voltage areas

persistent atrial fibrillation

electrogram mapping

artificial intelligence

ablation strategy

Ev-AIFib trial

fibrotic tissue

heart rhythm

personalized therapeutic strategies