Distinctive Patterns of Dominant Frequency Trajectory Behaviour in Persistent Atrial Fibrillation: Spatio-temporal Characterisation

Enhancing our understanding of the underlying AF behaviour is a key factor to contribute towards improving patient outcomes in special for persistent AF (persAF) patients. In this study different signal processing and visualisation techniques were developed and applied to simultaneous high density sets of intracardiac electrograms (EGMs) obtained from persAF. We demonstrated that DF of EGMs lacked in spatiotemporal stability, hence targeting sites of peak DF from a single time frame is unlikely to be a reliable ablation strategy. Tracking the centre of gravity (CGs) from the highest dominant frequency areas (HDFAs) revealed three distinct propagation behaviours favouring the cyclical and local activity. The cores of the HDFAs showed to be significantly more organised than their periphery. Realtime implementation was shown to be feasible with the use of Graphic Processing Units representing an innovation that is currently being considered as part of the decision to guide ablation therapy for persAF.