Electrophysiological Rotor Ablation in In-Silico Modeling of Atrial Fibrillation: Comparisons with Dominant Frequency, Shannon Entropy, and Phase Singularity

• Published in: PloS one Vol. 11; no. 2; p. e0149695
• Main Authors: Hwang, Minki, Song, Jun-Seop, Lee, Young-Seon, Li, Changyong, Shim, Eun Bo, Pak, Hui-Nam
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 24.02.2016; Public Library of Science (PLoS)
• Subjects: Ablation; Analysis; Atrial fibrillation; Atrial Fibrillation - physiopathology; Audio frequencies; Biology and Life Sciences; Cardiac arrhythmia; Cardiology; Catheters; Computational biology; Computer Simulation; Correlation; Diagnosis; Engineering and Technology; Entropy (Information theory); Fibrillation; Fourier transforms; Humans; Hypotheses; Medicine and Health Sciences; Models, Cardiovascular; Research and Analysis Methods; Rotors; Studies; Three dimensional models; Two dimensional analysis; Two dimensional models; Veins & arteries; South Korea
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0149695

Although rotors have been considered among the drivers of atrial fibrillation (AF), the rotor definition is inconsistent. We evaluated the nature of rotors in 2D and 3D in- silico models of persistent AF (PeAF) by analyzing phase singularity (PS), dominant frequency (DF), Shannon entropy (ShEn), and complex fractionated atrial electrogram cycle length (CFAE-CL) and their ablation. Mother rotor was spatiotemporally defined as stationary reentries with a meandering tip remaining within half the wavelength and lasting longer than 5 s. We generated 2D- and 3D-maps of the PS, DF, ShEn, and CFAE-CL during AF. The spatial correlations and ablation outcomes targeting each parameter were analyzed. 1. In the 2D PeAF model, we observed a mother rotor that matched relatively well with DF (>9 Hz, 71.0%, p<0.001), ShEn (upper 2.5%, 33.2%, p<0.001), and CFAE-CL (lower 2.5%, 23.7%, p<0.001). 2. The 3D-PeAF model also showed mother rotors that had spatial correlations with DF (>5.5 Hz, 39.7%, p<0.001), ShEn (upper 8.5%, 15.1%, p <0.001), and CFAE (lower 8.5%, 8.0%, p = 0.002). 3. In both the 2D and 3D models, virtual ablation targeting the upper 5% of the DF terminated AF within 20 s, but not the ablations based on long-lasting PS, high ShEn area, or lower CFAE-CL area. Mother rotors were observed in both 2D and 3D human AF models. Rotor locations were well represented by DF, and their virtual ablation altered wave dynamics and terminated AF.