Observable Atrial and Ventricular Fibrillation Episode Durations Are Conformant With a Power Law Based on System Size and Spatial Synchronization

Dhani Dharmaprani, Kathryn Tiver, Sobhan Salari Shahrbabaki, Evan V. Jenkins, Darius Chapman, Campbell Strong, Jing X. Quah, Ivaylo Tonchev, Luke O’Loughlin, Lewis Mitchell, Matthew Tung, Waheed Ahmad, Nik Stoyanov, Martin Aguilar, Steven A. Niederer, Caroline H. Roney, Martyn P. Nash, Richard H. Clayton, Stanley Nattel, Anand N. Ganesan

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Abstract

BACKGROUND: Atrial fibrillation (AF) and ventricular fibrillation (VF) episodes exhibit varying durations, with some spontaneously ending quickly while others persist. A quantitative framework to explain episode durations remains elusive. We hypothesized that observable self-terminating AF and VF episode lengths, whereby durations are known, would conform with a power law based on the ratio of system size and correlation length (L/ξ). 

METHODS: Using data from computer simulations (2-dimensional sheet and 3-dimensional left-atrial), human ischemic VF recordings (256-electrode sock, n=12 patients), and human AF recordings (64-electrode basket-catheter, n=9 patients; 16-electrode high definition-grid catheter, n=42 patients), conformance with a power law was assessed using the Akaike information criterion, Bayesian information criterion, coefficient of determination (R2, significance=P<0.05) and maximum likelihood estimation. We analyzed fibrillatory episode durations and L/ξ, computed by taking the ratio between system size (L, chamber/simulation size) and correlation length (xi, estimated from pairwise correlation coefficients over electrode/node distance). 

RESULTS: In all computer models, the relationship between episode durations and L/ξ was conformant with a power law (Aliev-Panfilov R2: 0.90, P<0.001; Courtemanche R2: 0.91, P<0.001; Luo-Rudy R2: 0.61, P<0.001). Observable clinical AF/ VF durations were also conformant with a power law relationship (VF R2: 0.86, P<0.001; AF basket R2: 0.91, P<0.001; AF grid R2: 0.92, P<0.001). L/ξ also differentiated between self-terminating and sustained episodes of AF and VF (P<0.001; all systems), as well as paroxysmal versus persistent AF (P<0.001). In comparison, other electrogram metrics showed no statistically significant differences (dominant frequency, Shannon Entropy, mean voltage, peak-peak voltage; P>0.05). 

CONCLUSIONS: Observable fibrillation episode durations are conformant with a power law based on system size and correlation length.

Original languageEnglish
Article numbere012684
Number of pages11
JournalCirculation: Arrhythmia and Electrophysiology
Volume17
Issue number7
Early online date28 Jun 2024
DOIs
Publication statusPublished - Jul 2024

Keywords

  • Atrial fibrillation
  • mechanisms
  • termination
  • ventricular fibrillation

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