Complexity and recurrence of body surface electrocardiograms correlate with estimated reentrant atrial activity using electrocardiographic imaging in atrial fibrillation patients

Abstract Background Complexity and signal recurrence metrics obtained from body surface potential mapping (BSPM) allow quantifying atrial fibrillation (AF) substrate complexity. This study aims to correlate electrocardiographic imaging (ECGI) detected reentrant patterns with BSPM-calculated signal c...

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Main Authors: Rubén Molero, Olivier Meste, Ralf Peeters, Joël Karel, Pietro Bonizzi, María S. Guillem
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Cardiovascular Disorders
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Online Access:https://doi.org/10.1186/s12872-025-04483-4
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author Rubén Molero
Olivier Meste
Ralf Peeters
Joël Karel
Pietro Bonizzi
María S. Guillem
author_facet Rubén Molero
Olivier Meste
Ralf Peeters
Joël Karel
Pietro Bonizzi
María S. Guillem
author_sort Rubén Molero
collection DOAJ
description Abstract Background Complexity and signal recurrence metrics obtained from body surface potential mapping (BSPM) allow quantifying atrial fibrillation (AF) substrate complexity. This study aims to correlate electrocardiographic imaging (ECGI) detected reentrant patterns with BSPM-calculated signal complexity and recurrence metrics. Methods BSPM signals were recorded from 28 AF patients (17 male, 11 women, 62.69 ± 8.09 y.o.), followed by ECGI calculation. Signal complexity and recurrence metrics were computed on BSPM and ECGI signals. Rotors per second and rotor duration were computed on ECGI signals for each atrium and the whole atrial surface. Correlation between BSPM metrics and ECGI reentrant patterns for the entire atrial surface and for left atrium (LA) and right atrium (RA) were analyzed. Results Atrial complexity and recurrence metrics strongly correlated when computed on BSPM and ECGI. Higher sample entropy and relative harmonic energy (RHE) correlated with rotors of short duration. The highest dominant frequency of the ECGI signals did not correlate with the reentrant activity of the ECGI. Higher short- and long-term recurrence of BSPM signals correlated with longer duration rotors, particularly for long-term recurrence (rLA=0.74 vs. rRA=0.42). Only ECGI-based reentrant parameters showed higher LA complexity compared to RA (p < 0.05). Conclusions BSPM metrics strongly correlate with metrics measured on ECGI signals. BSPM metrics indicate a more elevated atrial electro-structural remodeling aligned with more short-duration rotors from ECGI computations. Although BSPM delivers qualitative AF reentry data, ECGI remains essential for identifying regional substrate complexity.
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spelling doaj-art-4809ced3eaf747b6ad06da3063f82d032025-01-19T12:09:25ZengBMCBMC Cardiovascular Disorders1471-22612025-01-0125111310.1186/s12872-025-04483-4Complexity and recurrence of body surface electrocardiograms correlate with estimated reentrant atrial activity using electrocardiographic imaging in atrial fibrillation patientsRubén Molero0Olivier Meste1Ralf Peeters2Joël Karel3Pietro Bonizzi4María S. Guillem5ITACA Institute, Universitat Politècnica de ValènciaLaboratoire I3S, Université Côte d’Azur, CNRSDepartment of Advanced Computing Sciences, Maastricht UniversityDepartment of Advanced Computing Sciences, Maastricht UniversityDepartment of Advanced Computing Sciences, Maastricht UniversityITACA Institute, Universitat Politècnica de ValènciaAbstract Background Complexity and signal recurrence metrics obtained from body surface potential mapping (BSPM) allow quantifying atrial fibrillation (AF) substrate complexity. This study aims to correlate electrocardiographic imaging (ECGI) detected reentrant patterns with BSPM-calculated signal complexity and recurrence metrics. Methods BSPM signals were recorded from 28 AF patients (17 male, 11 women, 62.69 ± 8.09 y.o.), followed by ECGI calculation. Signal complexity and recurrence metrics were computed on BSPM and ECGI signals. Rotors per second and rotor duration were computed on ECGI signals for each atrium and the whole atrial surface. Correlation between BSPM metrics and ECGI reentrant patterns for the entire atrial surface and for left atrium (LA) and right atrium (RA) were analyzed. Results Atrial complexity and recurrence metrics strongly correlated when computed on BSPM and ECGI. Higher sample entropy and relative harmonic energy (RHE) correlated with rotors of short duration. The highest dominant frequency of the ECGI signals did not correlate with the reentrant activity of the ECGI. Higher short- and long-term recurrence of BSPM signals correlated with longer duration rotors, particularly for long-term recurrence (rLA=0.74 vs. rRA=0.42). Only ECGI-based reentrant parameters showed higher LA complexity compared to RA (p < 0.05). Conclusions BSPM metrics strongly correlate with metrics measured on ECGI signals. BSPM metrics indicate a more elevated atrial electro-structural remodeling aligned with more short-duration rotors from ECGI computations. Although BSPM delivers qualitative AF reentry data, ECGI remains essential for identifying regional substrate complexity.https://doi.org/10.1186/s12872-025-04483-4Atrial fibrillationElectrocardiographic imagingBody surface potential mappingElectrical complexityReentrant activity
spellingShingle Rubén Molero
Olivier Meste
Ralf Peeters
Joël Karel
Pietro Bonizzi
María S. Guillem
Complexity and recurrence of body surface electrocardiograms correlate with estimated reentrant atrial activity using electrocardiographic imaging in atrial fibrillation patients
BMC Cardiovascular Disorders
Atrial fibrillation
Electrocardiographic imaging
Body surface potential mapping
Electrical complexity
Reentrant activity
title Complexity and recurrence of body surface electrocardiograms correlate with estimated reentrant atrial activity using electrocardiographic imaging in atrial fibrillation patients
title_full Complexity and recurrence of body surface electrocardiograms correlate with estimated reentrant atrial activity using electrocardiographic imaging in atrial fibrillation patients
title_fullStr Complexity and recurrence of body surface electrocardiograms correlate with estimated reentrant atrial activity using electrocardiographic imaging in atrial fibrillation patients
title_full_unstemmed Complexity and recurrence of body surface electrocardiograms correlate with estimated reentrant atrial activity using electrocardiographic imaging in atrial fibrillation patients
title_short Complexity and recurrence of body surface electrocardiograms correlate with estimated reentrant atrial activity using electrocardiographic imaging in atrial fibrillation patients
title_sort complexity and recurrence of body surface electrocardiograms correlate with estimated reentrant atrial activity using electrocardiographic imaging in atrial fibrillation patients
topic Atrial fibrillation
Electrocardiographic imaging
Body surface potential mapping
Electrical complexity
Reentrant activity
url https://doi.org/10.1186/s12872-025-04483-4
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