Dominant Frequency Variability Mapping for Identifying Stable Drivers During Persistent Atrial Fibrillation Using Non-Contact Mapping

Catheter ablation is a widely-used therapy to treat atrial fibrillation (AF), but the identification of ablation targets remain challenging in persistent AF (persAF). Dominant frequency (DF) mapping has been shown to be spatiotemporally unstable in persAF, with DF variability (DFV) correlating with the spectral organisation index (OI). This study aims to assess DFV at ablation sites between patients with AF termination and non-termination. 10 persAF patients undergoing LA ablation were enrolled. AF was terminated in 4 patients after ablating highest DFs. 2048-channel virtual electrograms (Ensite Array) were analysed in Matlab. DFV index (DFVI) was proposed to quantify DF temporal stability. Mock ablation targets were identified based on DFVI and the percentage of region actually ablated was computed. Ablation sites in termination patients revealed higher OI and lower DFVI. In the termination group, a greater proportion of DFVI was ablated. Atrial regions with higher temporal stability and organisation may offer more precise locations of stable focal drivers and may lead to higher success in AF termination following ablation.

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