Prospective cross-sectional study using Poisson renewal theory to study phase singularity formation and destruction rates in atrial fibrillation (RENEWAL-AF): Study design

Jing Quah, Dhani Dharmaprani, Anandaroop Lahiri, Madeline Schopp, Lewis Mitchell, Joseph B. Selvanayagam, Rebecca Perry, Fahd Chahadi, Matthew Tung, Waheed Ahmad, Nikola Stoyanov, Majo X. Joseph, Cameron Singleton, Andrew D. McGavigan, Anand N. Ganesan

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Abstract

Background: Unstable functional reentrant circuits known as rotors have been consistently observed in atrial fibrillation and are mechanistically believed critical to the maintenance of the arrhythmia. Recently, using a Poisson renewal theory-based quantitative framework, we have demonstrated that rotor formation (λf) and destruction rates (λd) can be measured using in vivo electrophysiologic data. However, the association of λf and λd with clinical, electrical, and structural markers of atrial fibrillation phenotype is unknown. Methods: RENEWAL-AF is a multicenter prospective cross-sectional study recruiting adult patients with paroxysmal or persistent atrial fibrillation undergoing clinically indicated catheter ablation. Patients will undergo intraprocedural electrophysiologic atrial fibrillation mapping, with λf and λd to be determined from 2-minute unipolar electrogram recordings acquired before ablation. The primary objective will be to determine the association of λf and λdas markers of fibrillatory dynamics with clinical, electrical, and structural markers of atrial fibrillation clinical phenotype, measured by preablation transthoracic echocardiogram and cardiac magnetic resonance imaging. An exploratory objective is the noninvasive assessment of λf and λd using surface ECG characteristics via a machine learning approach. Results: Not applicable. Conclusion: This pilot study will provide insight into the correlation between λfd with clinical, electrophysiological, and structural markers of atrial fibrillation phenotype and provide a foundation for the development of noninvasive assessment of λfd using surface ECG characteristics will help expand the use of λfd in clinical practice.

Original languageEnglish
Pages (from-to)660-667
Number of pages8
JournalJournal of Arrhythmia
Volume36
Issue number4
DOIs
Publication statusPublished - Aug 2020

Bibliographical note

This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

Keywords

  • atrial fibrillation
  • multimodal imaging
  • poisson distribution

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