Abstract:

The treatment of atrial rhythm disorders such as atrial fibrillation has remained a major challenge predominantly for patients with severely remodeled substrate. Individualized ablation strategies beyond pulmonary vein isolation in combination with real-time assess- ment of ablation lesion formation have been striven for insistently. Current approaches for identifying arrhythmogenic regions predominantly rely on electrogram-based features such as activation time and voltage or electrogram fractionation as a surrogate for tissue pathology. Despite bending every effort, large-scale clinical trials have yielded ambiguous results on the efficacy of various substrate mapping approaches without significant improvement of patient outcomes.This work focuses on enhancing the understanding of electrogram features and local impedance measurements in the atria towards the extraction of clinically relevant and predic- tive substrate characteristics.Features were extracted from intra-atrial electrograms with particular reference to the un- derlying excitation patterns to address morphological alterations caused by structural and functional changes. ... mehr