S. Pollnow, G. Schwaderlapp, A. Loewe, and O. Dössel. Monitoring the dynamics of acute radiofrequency ablation lesion formation in thin-walled atria – a simultaneous optical and electrical mapping study. In Biomedical Engineering / Biomedizinische Technik, vol. 65(3) , pp. 327-341, 2020
Background Radiofrequency ablation (RFA) is a common approach to treat cardiac arrhythmias. During this intervention, numerous strategies are applied to indirectly estimate lesion formation. However, the assessment of the spatial extent of these acute injuries needs to be improved in order to create well-defined and durable ablation lesions. Methods We investigated the electrophysiological characteristics of rat atrial myocardium during an ex vivo RFA procedure with fluorescence-optical and electrical mapping. By analyzing optical data, the temporal growth of punctiform ablation lesions was reconstructed after stepwise RFA sequences. Unipolar electrograms (EGMs) were simultaneously recorded by a multielectrode array (MEA) before and after each RFA sequence. Based on the optical results, we searched for electrical features to delineate these lesions from healthy myocardium. Results Several unipolar EGM parameters were monotonically decreasing when distances between the electrode and lesion boundary were smaller than 2 mm. The negative component of the unipolar EGM [negative peak amplitude (Aneg)] vanished for distances lesser than 0.4 mm to the lesion boundary. Median peak-to-peak amplitude (Vpp) was decreased by 75% compared to baseline. Conclusion Aneg and Vpp are excellent parameters to discriminate the growing lesion area from healthy myocardium. The experimental setup opens new opportunities to investigate EGM characteristics of more complex ablation lesions.
Optical mapping is widely used as a tool to investigate cardiac electrophysiology in ex vivo preparations. Digital filtering of fluorescence-optical data is an important requirement for robust subsequent data analysis and still a challenge when processing data acquired from thin mammalian myocardium. Therefore, we propose and investigate the use of an adaptive spatio-temporal Gaussian filter for processing optical mapping signals from these kinds of tissue usually having low signal-to-noise ratio (SNR). We demonstrate how filtering parameters can be chosen automatically without additional user input. For systematic comparison of this filter with standard filtering methods from the literature, we generated synthetic signals representing optical recordings from atrial myocardium of a rat heart with varying SNR. Furthermore, all filter methods were applied to experimental data from an ex vivo setup. Our developed filter outperformed the other filter methods regarding local activation time detection at SNRs smaller than 3 dB which are typical noise ratios expected in these signals. At higher SNRs, the proposed filter performed slightly worse than the methods from literature. In conclusion, the proposed adaptive spatio-temporal Gaussian filter is an appropriate tool for investigating fluorescence-optical data with low SNR. The spatio-temporal filter parameters were automatically adapted in contrast to the other investigated filters.
Intracardiac electrogram recordings during atrial fibrillation (AFib) are characterized by irregular rhythms and complex morphologies. Hence, analysis in the time domain is a difficult task. The so called dominant frequency DF is a spectrum based approach that aims at finding the most relevant frequency in a signal providing information about the rate and dynamics of AFib. However, in recent years various studies reported controversial results regarding the clinical relevance of the DF. In this work, a definition of the DF at a fundamental scale is proposed as the rate at which action potentials are triggered in atrial cells. The most common method to estimate the DF in literature, labeled as DFSpec, is examined in comparison to the proposed definition. A signal processing study using synthetic signals verified that the DFSpec is stable for all changes in morphology of atrial activations. However, it is also demonstrated that the DFSpec becomes unstable for variations above 20% in the cycle length of a signal. Spectrum based DF estimation should be interpreted in a critical manner and is not advisable for study endpoints or clinical markers.