Left atrial spatial entropy: a novel tool for electrophysiological substrate characterization in atrial fibrillation

BackgroundElectrical remodeling has been linked to the progression and recurrence of atrial fibrillation (AF) after catheter ablation (CA). Substrate mapping based solely on a voltage amplitude electrogram (EGM) does not provide a comprehensive understanding of the left atrial (LA) disease. The aim...

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Main Authors: Lorenzo Gigli, Alberto Preda, Davide Coluzzi, Marta Sartore, Muhamed Vila, Marco Carbonaro, Matteo Baroni, Marisa Varrenti, Sara Vargiu, Fabrizio Guarracini, Antonio Frontera, Luigi Pannone, Gian Battista Chierchia, Carlo De Asmundis, Patrizio Mazzone, Roberto Sassi
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-11-01
Series:Frontiers in Physiology
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Online Access:https://www.frontiersin.org/articles/10.3389/fphys.2024.1474568/full
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author Lorenzo Gigli
Lorenzo Gigli
Alberto Preda
Davide Coluzzi
Marta Sartore
Muhamed Vila
Marco Carbonaro
Matteo Baroni
Marisa Varrenti
Sara Vargiu
Fabrizio Guarracini
Antonio Frontera
Luigi Pannone
Gian Battista Chierchia
Carlo De Asmundis
Patrizio Mazzone
Roberto Sassi
author_facet Lorenzo Gigli
Lorenzo Gigli
Alberto Preda
Davide Coluzzi
Marta Sartore
Muhamed Vila
Marco Carbonaro
Matteo Baroni
Marisa Varrenti
Sara Vargiu
Fabrizio Guarracini
Antonio Frontera
Luigi Pannone
Gian Battista Chierchia
Carlo De Asmundis
Patrizio Mazzone
Roberto Sassi
author_sort Lorenzo Gigli
collection DOAJ
description BackgroundElectrical remodeling has been linked to the progression and recurrence of atrial fibrillation (AF) after catheter ablation (CA). Substrate mapping based solely on a voltage amplitude electrogram (EGM) does not provide a comprehensive understanding of the left atrial (LA) disease. The aim of this study is to assess left atrial spatial entropy (LASE) from voltage maps routinely obtained during AF ablation to further characterize the LA substrate.Materials and MethodsHigh-density electroanatomic maps (EAMs) of 27 patients with paroxysmal or persistent AF undergoing routine CA were prospectively collected. Computational post-processing was performed on the voltage maps. Using the Shannon entropy model, the probability distribution of the amplitude range values associated with each point of the map was used to measure LASE. Finally, correlations between LASE and clinical and electrophysiological characteristics of AF were explored.ResultsLASE differentiated between patients with paroxysmal and persistent AF (6.45 ± 0.41 vs. 5.87 ± 0.53; p = 0.028) and patients with normal and abnormal LA substrate (6.42 ± 0.42 vs. 5.87 ± 0.56; p = 0.043), independent of the basal rhythm during EM acquisition (6.33 ± 0.41 vs. 6.11 ± 0.63; p = 0.619). Accordance between LASE and EAMs was assessed by ROC analysis (AUC: 0.81; C.I.: 0.62–0.99; Youden index: 6.06; sensitivity: 80%; and specificity: 80%). Patients with the lowest LASE reported AF recurrence at the follow-up.ConclusionLASE may play a role in the further characterization of the LA substrate and the type of AF, independent of basal rhythm.
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spelling doaj-art-44f8d64c0d704504abbe605a16f19ae52025-08-20T02:27:42ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2024-11-011510.3389/fphys.2024.14745681474568Left atrial spatial entropy: a novel tool for electrophysiological substrate characterization in atrial fibrillationLorenzo Gigli0Lorenzo Gigli1Alberto Preda2Davide Coluzzi3Marta Sartore4Muhamed Vila5Marco Carbonaro6Matteo Baroni7Marisa Varrenti8Sara Vargiu9Fabrizio Guarracini10Antonio Frontera11Luigi Pannone12Gian Battista Chierchia13Carlo De Asmundis14Patrizio Mazzone15Roberto Sassi16De Gasperis Cardio Center, Electrophysiology Unit, Niguarda Hospital, Milan, ItalyHeart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel – Vrije Universiteit Brussel, Brussels, BelgiumDe Gasperis Cardio Center, Electrophysiology Unit, Niguarda Hospital, Milan, ItalyDe Gasperis Cardio Center, Electrophysiology Unit, Niguarda Hospital, Milan, ItalyDepartment of Computer Science, University of Milan, Milan, ItalyDepartment of Computer Science, University of Milan, Milan, ItalyDe Gasperis Cardio Center, Electrophysiology Unit, Niguarda Hospital, Milan, ItalyDe Gasperis Cardio Center, Electrophysiology Unit, Niguarda Hospital, Milan, ItalyDe Gasperis Cardio Center, Electrophysiology Unit, Niguarda Hospital, Milan, ItalyDe Gasperis Cardio Center, Electrophysiology Unit, Niguarda Hospital, Milan, ItalyDe Gasperis Cardio Center, Electrophysiology Unit, Niguarda Hospital, Milan, ItalyDe Gasperis Cardio Center, Electrophysiology Unit, Niguarda Hospital, Milan, ItalyHeart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel – Vrije Universiteit Brussel, Brussels, BelgiumHeart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel – Vrije Universiteit Brussel, Brussels, BelgiumHeart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel – Vrije Universiteit Brussel, Brussels, BelgiumDe Gasperis Cardio Center, Electrophysiology Unit, Niguarda Hospital, Milan, ItalyDepartment of Computer Science, University of Milan, Milan, ItalyBackgroundElectrical remodeling has been linked to the progression and recurrence of atrial fibrillation (AF) after catheter ablation (CA). Substrate mapping based solely on a voltage amplitude electrogram (EGM) does not provide a comprehensive understanding of the left atrial (LA) disease. The aim of this study is to assess left atrial spatial entropy (LASE) from voltage maps routinely obtained during AF ablation to further characterize the LA substrate.Materials and MethodsHigh-density electroanatomic maps (EAMs) of 27 patients with paroxysmal or persistent AF undergoing routine CA were prospectively collected. Computational post-processing was performed on the voltage maps. Using the Shannon entropy model, the probability distribution of the amplitude range values associated with each point of the map was used to measure LASE. Finally, correlations between LASE and clinical and electrophysiological characteristics of AF were explored.ResultsLASE differentiated between patients with paroxysmal and persistent AF (6.45 ± 0.41 vs. 5.87 ± 0.53; p = 0.028) and patients with normal and abnormal LA substrate (6.42 ± 0.42 vs. 5.87 ± 0.56; p = 0.043), independent of the basal rhythm during EM acquisition (6.33 ± 0.41 vs. 6.11 ± 0.63; p = 0.619). Accordance between LASE and EAMs was assessed by ROC analysis (AUC: 0.81; C.I.: 0.62–0.99; Youden index: 6.06; sensitivity: 80%; and specificity: 80%). Patients with the lowest LASE reported AF recurrence at the follow-up.ConclusionLASE may play a role in the further characterization of the LA substrate and the type of AF, independent of basal rhythm.https://www.frontiersin.org/articles/10.3389/fphys.2024.1474568/fullatrial fibrillationleft atrial spatial entropycatheter ablationsubstrate characterizationmapping technologies
spellingShingle Lorenzo Gigli
Lorenzo Gigli
Alberto Preda
Davide Coluzzi
Marta Sartore
Muhamed Vila
Marco Carbonaro
Matteo Baroni
Marisa Varrenti
Sara Vargiu
Fabrizio Guarracini
Antonio Frontera
Luigi Pannone
Gian Battista Chierchia
Carlo De Asmundis
Patrizio Mazzone
Roberto Sassi
Left atrial spatial entropy: a novel tool for electrophysiological substrate characterization in atrial fibrillation
Frontiers in Physiology
atrial fibrillation
left atrial spatial entropy
catheter ablation
substrate characterization
mapping technologies
title Left atrial spatial entropy: a novel tool for electrophysiological substrate characterization in atrial fibrillation
title_full Left atrial spatial entropy: a novel tool for electrophysiological substrate characterization in atrial fibrillation
title_fullStr Left atrial spatial entropy: a novel tool for electrophysiological substrate characterization in atrial fibrillation
title_full_unstemmed Left atrial spatial entropy: a novel tool for electrophysiological substrate characterization in atrial fibrillation
title_short Left atrial spatial entropy: a novel tool for electrophysiological substrate characterization in atrial fibrillation
title_sort left atrial spatial entropy a novel tool for electrophysiological substrate characterization in atrial fibrillation
topic atrial fibrillation
left atrial spatial entropy
catheter ablation
substrate characterization
mapping technologies
url https://www.frontiersin.org/articles/10.3389/fphys.2024.1474568/full
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